Abstract
The infusion of high-dose intravenous IgG (IVIG) may result in clinical improvement and immunological changes in patients affected by connective tissue diseases. In our experience patients affected by severe rheumatoid arthritis derive a limited benefit from IVIG therapy, namely when this treatment is followed by a drop in CD8+ cell number. When IVIG infusion fails to induce a decrease in the number of CD8+ cells, the outcome seems to be better but the clinical remission is usually temporary in such severely affected patients. In patients affected by systemic lupus erythematosus, manifestations of the disease sensitive to IVIG included encephalitis, cytopenias and anti-cardiolipin-related recurrent fetal loss. Severe renal involvement should be considered as a counterindication to IVIG therapy, since renal function may rapidly deteriorate. Some cases of necrotizing vasculitis may also benefit from IVIG therapy. Despite the uncertain therapeutic value of IVIG in patients affected by connective tissue diseases, this regimen showed clinical efficacy in some cases and proved to interfere with the immunological mechanisms thought to sustain these diseases.
Published Version
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