A study of 20 SLE patients with intravenous immunoglobulin - clinical and serologic response
A study of 20 SLE patients with intravenous immunoglobulin - clinical and serologic response
复制标题
DOI：
10.1191/096120399678841007
复制
发表时间：
1999-01-01
期刊：
影响因子：
2.6
通讯作者：
Shoenfeld, Y
中科院分区：
文献类型：
--
作者：
Levy, Y;Sherer, Y;Shoenfeld, Y
目的：检测系统性红斑狼疮（SLE）患者静脉注射免疫球蛋白（IVIg）的临床反应，以及IVIg治疗SLE的临床反应是否伴随SLE相关自身抗体/抗体（Abs）及补体水平的改变。方法：对20例SLE患者每月给予高剂量（2 g/kg） IVIg治疗，疗程5 d。每例患者接受1-8个疗程的治疗。评估临床疗效、IVIg前后系统性狼疮活性测量（SLAM）评分、治疗前后及每个疗程前后的抗核抗体（ANA）、双链DNA （dsDNA）、SS-A或SS-B、ENA（可提取核抗原）、C-3、C-4水平。结果：20例患者中有17例（85%）在IVIg治疗后出现了有益的临床反应。很少有临床表现对治疗有更大的反应：关节炎、发热、血小板减少症和神经精神性狼疮。在IVIg前后评估的9例患者中，平均SLAM评分从19.3 +/- 4.7降至4 +/- 2.9 （P < 0.0001）。与无应答者相比，治疗应答者在IVIg疗程前补体和抗体水平有异常的趋势，同样，治疗应答者的异常水平比无应答者更有正常化的趋势。这些差异仅在IVIg疗程前的C-4和SS-A或SS-B水平方面具有统计学意义。结论：IVIg在SLE患者中有较高的应答率。临床表现、抗体和补体水平的结合可能有助于未来预测哪些SLE患者将从IVIg治疗中获益更多。
Objective: To test the clinical response of systemic lupus erythematosus (SLE) patients to intravenous immunoglobulins (IVIg), and whether the clinical response of IVIg treatment in SLE is accompanied by modification of SLE-associated autoantibodies/antibodies (Abs) and complement levels.Methods: Twenty SLE patients were treated with high-dose (2 g/kg) IVIg monthly, in a 5-d schedule. Each patient received between 1-8 treatment courses. They were evaluated for the clinical response, Systemic Lupus Activity Measure (SLAM) score before and after IVIg, levels of antinuclear antibody (ANA), dsDNA (double-stranded DNA), SS-A or SS-B, ENA (extractable nuclear antigens), C-3 and C-4 levels before and after the treatment, and before and after each treatment course.Results: A beneficial clinical response following IVIg treatment was noted in 17 out of 20 patients (85%). Few clinical manifestations responded more to treatment: arthritis, fever, thrombocytopenia, and neuropsychiatric lupus. In 9 patients evaluated before and after IVIg, mean SLAM score decreased from 19.3 +/- 4.7 to 4 +/- 2.9 (P < 0.0001). There was a tendency towards abnormal levels of complement and Abs before IVIg courses among the treatment responders compared with the non-responders, and similarly the former tended to have normalization of their abnormal levels more than the latter. These differences were found statistically significant only with respect to C-4 and SS-A or SS-B levels before IVIg courses.Conclusion: IVIg has a high response rate among SLE patients. A combination of clinical manifestations, Abs and complement levels may aid in the future in predicting who among SLE patients will benefit more from IVIg treatment.