Intravenous immunoglobulin G in the treatment of patients with chronic glomerulonephritis: clinical experience lasting 15 years.
In our study, we collected data on 116 patients with biopsy-proven idiopathic or lupus glomerulonephritis who were treated with high doses of intravenous immunoglobulin G (IVIG) (Veinoglobuline or Immunovenin-intact). In all patients a severe nephrotic syndrome (edema, proteinuria >6 g/24 h, serum albumin <22 g/24 h) had been observed. 34 patients had renal failure (serum creatinine up to 504 micromol/l) and 96 hypertension. 98 patients were previously for a long time treated with corticosteroids, immunosuppressors and anticoagulants without any effect. 18 patients had no therapy before IVIG. IVIG had been applied in a dose of 85 mg/kg/24 h 3 times every other day. Depending on the clinical improvement afterwards (in case of therapy resistance or relapse) these boli had been repeated in 84 patients after 1 month (and every 3 months for maintenance of remission) to 7 years. Proteinuria disappeared and full remission occurred in 36 patients. Partial remission was present in 48 patients. 32 patients went into end-stage renal failure and/or died (15 of them of a nonrenal cause). In 13/34 patients with impaired renal function serum creatinine levels go back to normal after treatment. Our results suggested that IVIG therapy may be recommended in patients unresponsive to aggressive conventional treatment.
Monova
Daniela
D
Clinic of Internal Medicine and Clinical Pharmacology, Medical University, University Hospital St. J Rilski, Sofia, Bulgaria. dmonova@hotmail.com
Belovezhdov
Nicolay
N
Altunkova
Iskra
I
Monov
Simeon
S
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002908:Chronic Disease; D005260:Female; D005921:Glomerulonephritis / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology / Q000627:therapeutic use*; D016756:Immunoglobulins, Intravenous / Q000276:immunology / Q000627:therapeutic use*; D007668:Kidney / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged
D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous