scholarly journals Intravenous Immunoglobulin in the Management of Lupus Nephritis

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Scott E. Wenderfer ◽  
Trisha Thacker
Keyword(s):  
Lupus Nephritis ◽  
Immune Responses ◽  
Intravenous Immunoglobulin ◽  
Lupus Erythematosus ◽  
Fc Receptors ◽  
Immunoglobulin Therapy ◽  
Mechanisms Of Action ◽  
Systemic Lupus ◽  
Humoral Immune ◽  
Humoral Immune Responses

The occurrence of nephritis in patients with systemic lupus erythematosus is associated with increased morbidity and mortality. The pathogenesis of lupus nephritis is complex, involving innate and adaptive cellular and humoral immune responses. Autoantibodies in particular have been shown to be critical in the initiation and progression of renal injury, via interactions with both Fc-receptors and complement. One approach in the management of patients with lupus nephritis has been the use of intravenous immunoglobulin. This therapy has shown benefit in the setting of many forms of autoantibody-mediated injury; however, the mechanisms of efficacy are not fully understood. In this paper, the data supporting the use of immunoglobulin therapy in lupus nephritis will be evaluated. In addition, the potential mechanisms of action will be discussed with respect to the known involvement of complement and Fc-receptors in the kidney parenchyma. Results are provocative and warrant additional clinical trials.

scholarly journals Infection with Opportunistic Bacteria Triggers Severe Pulmonary Inflammation in Lupus-Prone Mice

2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Wenchao Li ◽  
Weiwei Chen ◽  
Saisai Huang ◽  
Xiaojun Tang ◽  
Genhong Yao ◽  
...  
Keyword(s):  
Immune Responses ◽  
Lupus Erythematosus ◽  
Early Stage ◽  
Pulmonary Inflammation ◽  
Infection Model ◽  
Humoral Immune ◽  
Humoral Immune Responses ◽  
Opportunistic Bacteria ◽  
Enhanced Production ◽  
Immune Dysfunctions

Infection is a common cause of hospitalization and mortality in patients with systemic lupus erythematosus (SLE). How the underlying immune dysfunctions affect the antimicrobial immunity remains largely unknown. In the present study, employing the pulmonary infection model, we determined the antimicrobial defence of lupus-prone mice. After infecting with opportunistic bacterium Haemophilus influenzae (Hi), lupus-prone mice (B6/lpr) exhibited inefficient bacterial elimination and recovered slowly. They generated severer inflammation at the early stage of infection, as excessive accumulation of neutrophils and enhanced production of proinflammatory cytokines were observed in the lung. In addition, a large number of apoptotic cells were detected in the lungs of B6/lpr mice. For adaptive immune responses, B6/lpr mice were capable to generate enough protective Hi-specific Th17 cells. They evoked stronger Hi-specific γδ T17 response in both lungs and spleens. Unexpectedly, both CD4 and γδ T cells from lupus-prone mice showed deficiency in IFN-γ production. For humoral immune responses, compared with those of WT mice, the concentrations of Hi-specific IgA, IgM, and IgG, especially IgG, were significantly higher in the B6/lpr mice. Our findings suggest that lupus mice are capable to generate antibacterial immune responses; however, the overwhelming inflammation and overactivated immune responses increase the severity of infection.

Systemic lupus erythematosus presenting as Guillain-Barré syndrome

2021 ◽  
pp. practneurol-2020-002849
Author(s):  
Paul Christopher Kopanidis ◽  
Alisa Kane ◽  
Minh Anh Nguyen ◽  
Romesh Markus
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Plasma Exchange ◽  
Intravenous Immunoglobulin ◽  
Lupus Erythematosus ◽  
Guillain Barre Syndrome ◽  
Systemic Lupus ◽  
Guillain Barré Syndrome ◽  
Guillain Barré ◽  
New Diagnosis

A 37-year-old woman developed progressive symmetrical weakness with areflexia, consistent with Guillain-Barré syndrome. After initially briefly responding to intravenous immunoglobulin, her weakness progressed markedly. Further investigation identified a new diagnosis of systemic lupus erythematosus with lupus nephritis. Following additional plasma exchange and corticosteroids, the lupus activity remitted and she made a complete neurological recovery.

scholarly journals Intravenous immunoglobulin therapy in systemic lupus erythematosus-associated thrombocytopenia

2010 ◽  
Vol 33 (8) ◽  
pp. 1233-1239 ◽  
Author(s):  
William P. Maier ◽  
David S. Gordon ◽  
Robert F. Howard ◽  
Mansoor N. Saleh ◽  
Stephen B. Miller ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Intravenous Immunoglobulin ◽  
Lupus Erythematosus ◽  
Immunoglobulin Therapy ◽  
Systemic Lupus ◽  
Intravenous Immunoglobulin Therapy

scholarly journals Evaluation of Intravenous Immunoglobulin G treatment in Outpatients Rheumatology Practice

Acta Medica ◽  
2021 ◽  
pp. 1-8
Author(s):  
Berkan Armağan ◽  
Bayram Farisoğulları ◽  
Hakan Oral ◽  
Levent Kılıç ◽  
Şule Apraş Bilgen ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Intravenous Immunoglobulin ◽  
Lupus Erythematosus ◽  
Immunoglobulin Therapy ◽  
Second Line ◽  
Systemic Lupus ◽  
Intravenous Immunoglobulin Therapy ◽  
Rheumatological Disease ◽  
Immunoglobulin Treatment ◽  
Rheumatological Diseases

Objective: Intravenous immunoglobulin is an alternative therapeutic agent that can be used off-label in many autoimmune rheumatological diseases. The aim of this study is to evaluate the autoimmune rheumatological diseases characteristics in which intravenous immunoglobulin therapy is used and the efficacy and safety of this therapy. Methods and Methods: We performed a retrospective review of 133 patients with autoimmune rheumatological disease who received at least 1 course of intravenous immunoglobulin treatment at Hacettepe University Rheumatology Outpatient Clinic between January 2013 and December 2020. The autoimmune rheumatological disease demographic and clinical features, organ involvements, treatment phases (primary-secondary or infection), treatment responses and adverse effects were evaluated. Results: A total of 79% (n=105) patients were female and the mean±SD age was 45.5±16.9 years. The most common underlying rheumatic diseases were systemic lupus erythematosus (35%, n=47) and dermatomyositis/polymyositis (35%, n=47). Intravenous immunoglobulin therapy was most commonly used for resistant/relapsed myositis and haematological involvement. The median (IQR) intravenous immunoglobulin treatment course was 6.5 (13) and the duration of intravenous immunoglobulin treatment was 10.8 (24) months. Although it is used as second-line therapy in 77% of patients, complete clinical response was observed in 32% and partial response in 47%. There was a significant reduction in the median (IQR) steroid doses (methylprednisolone or equivalent dose) patients received from baseline after intravenous immunoglobulin treatment [30 (33) vs 8 (12), p<0.0001]. It was observed that the use of conventional disease-modifying antirheumatic drugs decreased after intravenous immunoglobulin treatment and the use of rituximab increased. Adverse effects associated with intravenous immunoglobulin treatment (10%) and discontinuation (4%) were found to be very low. Conclusion: Intravenous immunoglobulin treatment was commonly given in systemic lupus erythematosus and dermatomyositis/polymyositis patients because of hematological involvement and resistant/relapsed myositis in our study, respectively. Although it is mainly the second-line treatment, two-thirds of the patients achieved a complete/partial response. Side effects and related discontinuation due to intravenous immunoglobulin treatment are very few.

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