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  • Title: Clinical efficacy of intravenous immunoglobulin for patients with MPO-ANCA-associated rapidly progressive glomerulonephritis.
    Author: Ito-Ihara T, Ono T, Nogaki F, Suyama K, Tanaka M, Yonemoto S, Fukatsu A, Kita T, Suzuki K, Muso E.
    Journal: Nephron Clin Pract; 2006; 102(1):c35-42. PubMed ID: 16174989.
    Abstract:
    BACKGROUND: To determine whether intravenous immunoglobulin (IVIg) can control disease activity in patients with myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA)-associated rapidly progressive glomerulonephritis (RPGN). METHODS: Twelve patients with serologically and histologically confirmed MPO-ANCA-associated RPGN (7 men, 5 women; mean age 71 +/- 3 years) received IVIg (400 mg/kg/day) alone for 5 days. The effects of IVIg were evaluated by white blood cell counts, serum C-reactive protein levels, Birmingham Vasculitis Activity Score, rate of change in reciprocal creatinine (1/Cre), and plasma tumor necrosis factor-alpha levels after IVIg administration. Corticosteroids with or without cyclophosphamide were commenced after IVIg. RESULTS: After IVIg treatment, a significant decrease was observed in white blood cell count (p < 0.05), C-reactive protein values (p < 0.001), and Birmingham Vasculitis Activity Score (p < 0.001) concomitant with the amelioration of systemic symptoms. The rate of change in 1/Cre significantly improved (p < 0.05). Plasma tumor necrosis factor-alpha levels that were significantly elevated in patients before IVIg compared with normal controls (p < 0.0001), rapidly declined after IVIg with a significant reduction (p < 0.05). Three months post-treatment with IVIg, all patients showed improvement of disease without serious infectious complications. CONCLUSION: IVIg is a potential component of remission induction therapy for patients with MPO-ANCA-associated RPGN.
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