Intravenous immunoglobulins in peripheral neuropathy associated with vasculitis

• Published in: Annals of the rheumatic diseases Vol. 62; no. 12; pp. 1221 - 1223
• Main Authors: Levy, Y, Uziel, Y, Zandman, G G, Amital, H, Sherer, Y, Langevitz, P, Goldman, B, Shoenfeld, Y
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and European League Against Rheumatism 01.12.2003; BMJ; BMJ Publishing Group Ltd; BMJ Publishing Group LTD
• Subjects: Adult; Aged; Biological and medical sciences; Biopsy; Case reports; Child; Churg-Strauss Syndrome - complications; Concise Report; Cryoglobulinemia - complications; Drug dosages; Electromyography; EMG electromyography; Female; Hepatitis; Hepatitis C - complications; Humans; immunoglobulins; Immunoglobulins, Intravenous - therapeutic use; Immunomodulators; Influenza; Influenza Vaccines - adverse effects; intravenous immunoglobulin; Ischemia; IVIg; Lupus; Lupus Erythematosus, Systemic - complications; Male; Medical sciences; Middle Aged; Nervous system; Patients; Peripheral Nervous System Diseases - complications; Peripheral Nervous System Diseases - therapy; Peripheral neuropathy; Pharmacology. Drug treatments; Sarcoidosis; Sarcoidosis - complications; Serology; Sjogren's Syndrome - complications; Sjögren’s syndrome; SLE; Steroids; systemic lupus erythematosus; Tomography; vasculitis; Vasculitis - complications; Germany; Vascular disease; Human; Nervous system diseases; Chemotherapy; Immunoglobulins; Association; Treatment; Vasculitis; Intravenous administration; Cardiovascular disease; Peripheral nerve disease; Peripheral neuropathy
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/ard.2002.003996

Background: Peripheral neuropathy is a prominent feature of the systemic and secondary vasculitides. Usually, it is responsive to corticosteroids, but in certain cases it may be resistant to corticosteroid or immunosuppressive treatment, or both. Objective: To present patients who exhibited various inflammatory diseases accompanied with vasculitic peripheral neuropathies for which intravenous immunoglobulin (IVIg) was used for treatment. Methods: Six patients with Sjögren’s syndrome, systemic lupus erythematosus (SLE), vaccination induced vasculitis, Churg-Strauss vasculitis, mixed cryoglobulinaemia associated with hepatitis C infection, or sarcoidosis were included. All developed vasculitic peripheral neuropathy, and were treated with high dose IVIg (2 g/kg body weight). The patients were followed up for 1–5 years after this treatment. Results: In four patients (Sjögren’s syndrome, Churg-Strauss vasculitis, SLE, and vaccination induced vasculitis) the neuropathy resolved after IVIg treatment. Conclusion: IVIg may be beneficial in cases of resistant vasculitic peripheral neuropathy. IVIg should probably be considered as a sole or adjuvant treatment for patients with contraindications to conventional treatment, or alternatively, for patients in whom conventional treatment has failed.