title: Response of vasculitic peripheral neuropathy to intravenous immunoglobulin.
abstract: Peripheral neuropathy is a prominent feature of the systemic and secondary vasculitides. Usually, it responds to corticosteroids therapy, but in certain cases it may resist corticosteroid or immunosuppressive treatment, or both. The objective of this study is to present case reports of patients who exhibited various inflammatory diseases, accompanied with vasculitic peripheral neuropathies, for which intravenous immunoglobulin (IVIg) was used for treatment. The study included 10 patients with the following: Sjögren's syndrome (1), systemic lupus erythematosus (2), vaccination-induced vasculitis (1), Churg-Strauss vasculitis (1), mixed cryoglobulinemia (2), polyarteritis nodosa (1), sarcoidosis (1), and scleroderma (1). All developed vasculitic peripheral neuropathy and were treated with 1-13 cycles of high-dose IVIg (2 g/kg body weight). The patients were followed up for 1-5 years after this treatment. Results showed that in all but two patients (mixed cryoglobulinemia associated with hepatitis C and sarcoidosis), neuropathy improved or completely resolved after IVIg treatment. In conclusion, IVIg may be beneficial in cases of resistant vasculitic peripheral neuropathy. IVIg should probably be considered as a sole or adjuvant treatment in patients for whom conventional treatment is contraindicated, or for patients in whom conventional treatment has failed.
authors.affiliation: Department of Medicine E, Meir Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Yair
authors.initials: Y
authors.lastname: Levy
authors.forename: Yosef
authors.initials: Y
authors.lastname: Uziel
authors.forename: Giesele
authors.initials: G
authors.lastname: Zandman
authors.forename: Pnina
authors.initials: P
authors.lastname: Rotman
authors.forename: Hawared
authors.initials: H
authors.lastname: Amital
authors.forename: Yaniv
authors.initials: Y
authors.lastname: Sherer
authors.forename: Pnina
authors.initials: P
authors.lastname: Langevitz
authors.forename: Boleck
authors.initials: B
authors.lastname: Goldman
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Shoenfeld
mesh_terms: D002648:Child; D015267:Churg-Strauss Syndrome / Q000188:drug therapy; D003449:Cryoglobulinemia / Q000209:etiology; D003586:Cytomegalovirus Infections / Q000150:complications; D005260:Female; D006526:Hepatitis C / Q000139:chemically induced; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy*; D014657:Vasculitis / Q000150:complications*
chemical_list: D016756:Immunoglobulins, Intravenous