Granulomatosis with polyangiitis and intravenous immunoglobulins: a case series and review of the literature

Autoimmun Rev. 2015 Aug;14(8):659-64. doi: 10.1016/j.autrev.2015.03.005. Epub 2015 Mar 24.

Abstract

Granulomatosis with polyangiitis, formerly known as Wegener's granulomatosis or disease, is a systemic, necrotizing small-vessel vasculitis, belonging to the group of anti-neutrophil cytoplasm antibody vasculitis. The therapeutic strategy includes, in most cases, corticosteroids associated, at least in severe forms of the disease, with immunosuppressive agents: cyclophosphamide and rituximab to induce remission, methotrexate, azathioprine and mycophenolate mofetil to prevent relapses. Intravenous immunoglobulins represent an alternative adjuvant therapy. We described 5 cases of patients with granulomatosis with polyangiitis treated with monthly high-dose intravenous immunoglobulins (500mg/kg/daily for 3 consecutive days for 9months). No patients experienced adverse reactions, and 4 patients (80%) achieved a complete remission after 9 courses of this therapy, which was maintained also 3months later, although we are unable to determine whether improvement in outcomes was a direct result of the IVIG. We also discussed the beneficial effects of intravenous immunoglobulins in patients suffering from granulomatosis with polyangiitis, reporting the previously published data.

Keywords: ANCA-vasculitis; Granulomatosis with polyangiitis; Intravenous immunoglobulins.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • Drug Therapy, Combination
  • Female
  • Granulomatosis with Polyangiitis / drug therapy*
  • Granulomatosis with Polyangiitis / immunology*
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use*
  • Male
  • Middle Aged
  • Recurrence
  • Remission Induction

Substances

  • Immunoglobulins, Intravenous