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Ann Rheum Dis 2003;62:1221-1223 doi:10.1136/ard.2002.003996
  • Concise report

Intravenous immunoglobulins in peripheral neuropathy associated with vasculitis

  1. Y Levy1,
  2. Y Uziel4,
  3. G G Zandman1,2,
  4. H Amital1,
  5. Y Sherer1,
  6. P Langevitz2,
  7. B Goldman3,
  8. Y Shoenfeld1
  1. 1Department of Medicine B and the Centre for Autoimmune Diseases, Sheba Medical Centre Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Israel
  2. 2Rheumatic Diseases Unit, Sheba Medical Centre Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Israel
  3. 3Institute of Genetics, Sheba Medical Centre Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Israel
  4. 4Paediatric Rheumatology Unit, Sapir Medical Centre, Kfar Saba, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
  1. Correspondence to:
    Professor Y Shoenfeld
    Department of Medicine “B”, Sheba Medical Centre, Tel-Hashomer, 52621, Israel; shoenfelpost.tau.ac.il
  • Accepted 28 January 2003

Abstract

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.

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