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[High dosage intravenous immunoglobulin (IVIG) therapy in therapy-refractory ANCA-negative, necrotizing vasculitis]
P Altmeyer1, D Seifarth, M Bacharach-Buhles
1Dermatologische Klinik, Ruhr-Universität Bochum.
7 patients (5 female, 2 male; age: 22-81 years; average age = 58.1 J) with recurrent necrotizing ANCA-negative, non leucocytoclastic vasculitis, were enrolled into this study. Disease was resistant to prior conservative therapy, and therefore patients received high dose intravenous immuno-globulin (IVIG)--(dose: 1.0 g/kg body weight daily dose 0.25 g/kg body weight over 4 consecutive days). All patients responded rapidly to this therapeutic regimen. Specifically immediate pain relief was striking. Complete clearance of disease was observed in 5 out of 7 patients within 6 months while receiving IVIG (0.5 g/kg body weight) every 4 weeks for one year. In 2 out of 5 patients ulceration and vasculitis healed completely and therapy could be stopped after 6 months. In one patient treatment had to be discontinued due to decreasing kidney function. The data presented demonstrate that IVIG is an effective and valuable therapeutic modality in treatment of severe vasculitis resistant to conventional therapy. However consideration of costs, effectiveness and possible side effects is needed for this therapeutic regime.
7 patients (5 female, 2 male; age: 22-81 years; average age = 58.1 J) with recurrent necrotizing ANCA-negative, non leucocytoclastic vasculitis, were enrolled into this study. Disease was resistant to prior conservative therapy, and therefore patients received high dose intravenous immuno-globulin (IVIG)--(dose: 1.0 g/kg body weight daily dose 0.25 g/kg body weight over 4 consecutive days). All patients responded rapidly to this therapeutic regimen. Specifically immediate pain relief was striking. Complete clearance of disease was observed in 5 out of 7 patients within 6 months while receiving IVIG (0.5 g/kg body weight) every 4 weeks for one year. In 2 out of 5 patients ulceration and vasculitis healed completely and therapy could be stopped after 6 months. In one patient treatment had to be discontinued due to decreasing kidney function. The data presented demonstrate that IVIG is an effective and valuable therapeutic modality in treatment of severe vasculitis resistant to conventional therapy. However consideration of costs, effectiveness and possible side effects is needed for this therapeutic regime.