title: Safety and infectious prophylaxis of intravenous immunoglobulin in elderly patients with membranous nephropathy.
abstract: A variety of infections has been recognized as an important cause of morbidity and mortality in patients with nephrotic syndrome, and membranous nephropathy is a common cause of this in the elderly. The reasons for infection risk are due to oedema complications, urinary loss of factor B and D of the alternative complement pathway, cellular immunity, granulocyte chemotaxis, hypogammaglobulinemia with serum IgG levels below 600 mg/dL, and secondary effects of immunosuppressive therapy. Many different prophylactic interventions have been used for reducing the risks of infection in these patients but recommendations for routine use are still lacking. We report two membranous nephropathy cases in the elderly in which Intravenous immunoglobulin were useful in long-term infectious prophylaxis, showing safety in renal function. During immunosuppressant therapy in membranous nephropathy, intravenous immunoglobulin without sucrose are a safe therapeutic option as prophylaxis in those patients with nephrotic syndrome and IgG levels below 600 mg/dL. The long-term goal of infection prevention in these patients is to reduce mortality, prolong survival and improve quality of life.
authors.affiliation: Department of Clinical Medicine, Clinical Immunology Unit, Scleroderma Center, Sapienza University of Rome, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Molinaro
authors.affiliation: Department of Clinical Medicine, Nephrology Unit, Sapienza University of Rome, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Barbano
authors.affiliation: Department of Clinical Medicine, Clinical Immunology Unit, Scleroderma Center, Sapienza University of Rome, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Rosato
authors.affiliation: Department of Clinical Medicine, Nephrology Unit, Sapienza University of Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Cianci
authors.affiliation: Department of Clinical Medicine, Sapienza University of Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Di Mario
authors.affiliation: Department of Clinical Medicine, Clinical Immunology Unit, Scleroderma Center, Sapienza University of Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Quarta
authors.affiliation: Department of Clinical Medicine, Sapienza University of Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Sardo
authors.affiliation: Department of Clinical Medicine, Clinical Immunology Unit, Scleroderma Center, Sapienza University of Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Salsano
authors.affiliation: Department of Clinical Medicine, Sapienza University of Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Amoroso
authors.affiliation: Department of Clinical Medicine, Sapienza University of Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Gigante
mesh_terms: D000367:Age Factors; D000368:Aged; D001424:Bacterial Infections / Q000382:microbiology / Q000517:prevention & control*; D004334:Drug Administration Schedule; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D016867:Immunocompromised Host; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage* / Q000009:adverse effects; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008297:Male; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents