Jpn. J. Infect. Dis., 57, S17-S18, 2004
To see a printable version of the article
in the Adobe file format, click this [PDF] link.
Intravenous Immunoglobulin (IVIg) Therapy
in MPO-ANCA Related Polyangiitis with Rapidly Progressive Glomerulonephritis
in Japan
Eri Muso*, Toshiko Ito-Ihara1,
Takahiko Ono2, Enyu Imai3, Kunihiro Yamagata4,
Akira Akamatsu5 and Kazuo Suzuki6
Division of Nephrology, Kitano Hospital, The Tazuke Kofukai
Medical Research Institute, Osaka, 1Department
of Nephrology, Cardiovascular Medicine, Graduate School of Medicine,
Kyoto University, Kyoto, 2Department
of Clinical Pharmacology & Therapeutics, School of Pharmaceutical
Sciences, University of Shizuoka, Shizuoka, 3Department
of Internal Medicine and Therapeutics, Osaka University Graduate
School of Medicine, Osaka, 4Department of Nephrology,
Institute of Clinical Medicine, University of Tsukuba, Ibaraki,
5Department of Nephrology, Ehime Prefecture Hospital,
Ehime, 6Department of Bioactive Molecules, National
Institute of Infectious Diseases, Tokyo, Japan
*Corresponding author: muso@kitano-hp.or.jp
SUMMARY: For 30 myeloperoxidase (MPO) antineutrophil cytoplasmic
antibody (ANCA) related rapidly progressive glomerulonephritis
patients (male 17, female 13 , average age of 68 +/- 11.8 years
old), intravenous immunoglobulin (IVIg) (400 mg/kg/day) was administered
for 5 consecutive days before or along with conventional immunosuppressive
therapy in Japan. Twenty patients were treated with IVIg before
the start or newly increase of conventional therapy and evaluated
the independent effect of this therapy. In these patients, just
after IVIg, significant decrease of CRP from 8.61 +/- 5.77 to
5.47+/- 4.50 mg/dl (P < 0.001) was noted with improvement of
elevated serum creatinine in 12 out of 19 patients (63%). In the
analysis of the overall outcome of 30 patients, at 3 months after
IVIg and following conventional therapy, no patients showed renal
death except 4 for whom hemodialysis had been started before IVIg.
At 6 months, renal survival rate were 92% (newly renal death 2
out of 26) and 2 patients died due to cerebral bleeding (survival
rate was 93%). No fatal infection was noted. IVIg might be the
potent inducible therapy which can be promoted before the beginning
of conventional immunosuppressant treatment for relatively aged
and lower immunopotent MPO-ANCA patients in Japan.