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Three cases of systemic lupus erythematosus and review of the mechanisms concerning treatment with intravenous immunoglobulins (IVIG).
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Angel Alberto Justiz-Vaillant *   1, Belkis Ferrer-Cosme2 , Niurka Ramirez hernandez3 |
1- University of the West Indies. Saint Augustine. Trinidad and Tobago , angel.vaillant@sta.uwi.edu
2- Saturnino Lora Hospital. Cuba
3- Freyre de Andrade Hospital |
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Abstract: (2800 Views) |
The systemic lupus erythematosus (SLE) is an autoimmune disorder with a broad array of clinical signs. In this research, we aimed to use intravenous immunoglobulins (IVIG) called intacglobin as monotherapy to manage an SLE in three patients. Laboratory investigations for SLE diagnosis were done, including the detection of anti-nuclear antibodies (ANA) and SLE confirmation by detecting high titers of anti-dsDNA antibodies. C3 and C4 serum levels were assessed as well as the determination of immunoglobulins. The SLEDAI score was measured to decide whether a significant degree of disease activity existed and as a prognostic value. The evaluation of any chest infection was performed by chest-X-ray. The patients were treated with five to ten g/day of IVIG for six consecutive days, and after that, five to ten g/monthly. The immunological evaluation demonstrated that patients presented with a flare of SLE with high titers of ANA and anti-dsDNA antibodies were detected, low C3 and C4, and elevated immunoglobulins levels. The SLEDAI score falls from 10 to below 3, and the chest infections in some patients cleared up. The postulated IVIG's mechanisms of action demonstrated that it could be used as immunosuppressor, immunomodulator, and antimicrobial in patients with SLE.
The systemic lupus erythematosus (SLE) is an autoimmune disorder with a broad array of clinical signs. In this research, we aimed to use intravenous immunoglobulins (IVIG) called intacglobin as monotherapy to manage an SLE in three patients. Laboratory investigations for SLE diagnosis were done, including the detection of anti-nuclear antibodies (ANA) and SLE confirmation by detecting high titers of anti-dsDNA antibodies. C3 and C4 serum levels were assessed as well as the determination of immunoglobulins. The SLEDAI score was measured to decide whether a significant degree of disease activity existed and as a prognostic value. The evaluation of any chest infection was performed by chest-X-ray. The patients were treated with five to ten g/day of IVIG for six consecutive days, and after that, five to ten g/monthly. The immunological evaluation demonstrated that patients presented with a flare of SLE with high titers of ANA and anti-dsDNA antibodies were detected, low C3 and C4, and elevated immunoglobulins levels. The SLEDAI score falls from 10 to below 3, and the chest infections in some patients cleared up. The postulated IVIG's mechanisms of action demonstrated that it could be used as immunosuppressor, immunomodulator, and antimicrobial in patients with SLE.
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| Keywords: Systemic lupus erythematosus (SLE), Intravenous immunoglobulins (IVIG), Autoantibody, Autoimmune disease, Pneumonia. |
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Type of Study: Case Series |
Subject:
Immunology
Received: 2021/02/25 | Accepted: 2022/01/12 | Published: 2022/01/12
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