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- Title
Intravenous immunoglobulin therapy in immunoglobulin A vasculitis with gastrointestinal tract involvement.
- Authors
Öner, Nimet; Çelikel, Elif; Tekin, Zahide Ekici; Güngörer, Vildan; Kurt, Tuba; Tekgöz, Pakize Nilüfer; Sezer, Müge; Karagöl, Cüneyt; Coşkun, Serkan; Kaplan, Melike Mehveş; Polat, Merve Cansu; Acar, Banu Çelikel
- Abstract
Objective: The aim of this study is to evaluate the outcomes of patients who received intravenous immunoglobulin (IVIG) for immunoglobulin A vasculitis (IgAV) with gastrointestinal (GI) tract involvement, and to determine the differences between the groups that responded to IVIG and those that did not. Methods: This retrospective study comprised 152 patients with IgAV between 2018 and 2022. Sixty-five patients (43%) had GI tract involvement. Patients with IgAV-GI involvement who had been treated with IVIG were evaluated. Patients were classified with IgAV according to the 2008 Ankara-EULAR/PRINTO/PRES. Their demographics, presentation, and management are reported. Results: Twelve (7 boys/5 girls) of these patients were treated with IVIG. The median age was 90.1 (31–177) months. The mean follow-up period was 30.6 ± 9.9 months. All patients had skin involvement, joint involvement (arthralgia or arthritis), and abdominal pain. All 12 patients were given steroids (30 mg/kg/day pulse methylprednisolone for 3–7 days, followed by 2 mg/kg/day steroids) before IVIG. Nine patients received cyclophosphamide treatment (four before IVIG and five after IVIG). Complete remission was achieved in 5 of the patients with IVIG. Four patients were diagnosed with IgAV concomitant familial Mediterranean fever, and colchicine treatment was initiated. Conclusions: IVIG may be used in steroids and/or immunosuppressive drug resistant IgAV. It can be considered as a treatment option, especially in patients with multi-organ/system involvement, comorbid inflammatory diseases such as familial Mediterranean fever, and in patients with IgAV-GI tract involvement resistant to standard treatment in the advanced pediatric age group.
- Subjects
INTRAVENOUS therapy; SEROTHERAPY; GASTROINTESTINAL system; FAMILIAL Mediterranean fever; VASCULITIS; SCHOENLEIN-Henoch purpura; JOINT pain
- Publication
Clinical & Experimental Medicine, 2023, Vol 23, Issue 5, p1773
- ISSN
1591-8890
- Publication type
Article
- DOI
10.1007/s10238-022-00950-w