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Intravenous immunoglobulins may have role in vasculitic neuropathy

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Intravenous immunoglobulins may be beneficial in vasculitic peripheral neuropathy, especially in acute multisystem diseases such as systemic lupus erythematosus and Sjögren’s syndrome.

Treatment with intravenous immunoglobulins may be considered as the sole or as adjuvant treatment, particularly in patients in whom other immunosuppressive treatment has failed.

A study from Israel followed six patients with various inflammatory diseases accompanied by vasculitic peripheral neurophysiological that were unresponsive to conventional immunosuppressive treatment. Two patients had an acute peripheral neuropathy and four a chronic one.

All patients received the regular high intravenous dose of immunoglobulin and the investigators followed their progress by noting subjective clinical improvement, and serological neurophysiological investigations.

Four patients responded to the treatment, including the two patients with acute neuropathies. The patients with sarcoidosis and mixed cryoglobulinaemia did not respond.

The investigators think that the beneficial effects of intravenous immunoglobulin in the four patients are multifactorial, acting through complement deactivation, receptor blockade, anti-idiotypes, and modulation of cytokine production.

Patients were more likely to achieve remission when treated during an acute or subacute phase, rather than after longstanding disease.

Intravenous immunoglobulin was safe in all patients and did not cause any adverse effects.