Intravenous immunoglobulins in peripheral neuropathy associated with vasculitis

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Intravenous immunoglobulins in peripheral neuropathy associated with

vasculitis

Y Levy1, Y Uziel4, G G Zandman1,2, H Amital1, Y Sherer1, P Langevitz2, B

Goldman3 and Y Shoenfeld1

1 Department of Medicine B and the Centre for Autoimmune Diseases, Sheba

Medical Centre Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv

University, Israel

2 Rheumatic Diseases Unit, Sheba Medical Centre Tel-Hashomer, Sackler

Faculty of Medicine, Tel-Aviv University, Israel

3 Institute of Genetics, Sheba Medical Centre Tel-Hashomer, Sackler

Faculty of Medicine, Tel-Aviv University, Israel

4 Paediatric Rheumatology Unit, Sapir Medical Centre, Kfar Saba, Sackler

Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

Correspondence to:

Professor Y Shoenfeld

Department of Medicine " B " , Sheba Medical Centre, Tel-Hashomer, 52621,

Israel; shoenfel@...

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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