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Table of Contents
Vol. 53, No. 4, 1989
Issue release date: 1989
Section title: Original Paper
Nephron 1989;53:303–310
(DOI:10.1159/000185772)

Improvement of Histological and Immunological Change in Steroid and Immunosuppressive Drug-Resistant Lupus nephritis by High-Dose Intravenous Gamma Globulin

Lin C.-Y.a · Hsu H.-C.b · Chiang H.c
Departments of aMedical Research and cPediatrics and Pathology, Veterans General Hospital, and bDepartments of Pathology, College of Medicine, National Taiwan University, Taipei, Taiwan

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Accepted: March 31, 1989
Published online: December 10, 2008
Issue release date: 1989

Number of Print Pages: 8
Number of Figures: 0
Number of Tables: 0

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

For additional information: http://www.karger.com/NEF

Abstract

From July 1984 to December 1987,9 patients with lupus nephritis did not respond to the administration of two courses of methylprednisolone pulse therapy and cyclophosphamide treatment for 56 days. Therefore, high-dose intravenous human γ-globulin (IVIG) was administrated. Before IVIG therapy, renal biopsy showed class IV lupus nephritis in 5 cases, class V in 2 cases, and class IV with V in 2 cases. Immunofiuorescence of the renal biopsy showed heavy IgG deposits along the glomerular capillary walls. These heavy glomerular IgG deposits were dissociated after in vitro incubation of the cryostat kidney sections with plasmin-treated, PEG-treated, sulfonated human γ-globulin and a human Fc fragment, as evidenced by a dramatic decrease or even absence of fluorescent intensity. After high-dose IVIG treatment, 3 out of 5 cases of class IV lupus nephritis had a good response with decreased proteinuria and creatinine; serum C3, C4 levels and CH50 hemolytic activity also increased. The glomerular IgG deposits decreased in the follow-up biopsy. Pathologically, 2 of them transformed into class lib. The capacity to synthesize immunoglobulin after pokeweed mitogen stimulation was reduced and the circulating immune complexes (CIC) lowered after high-dose IVIG treatment. In the others there was partial response. These clinical and immunological improvements after high-dose IVIG therapy are probably related to the modulation of macrophage-T cell function and enhancement of suppressor T cell function. The toxicity of high dose IVIG was minimal, but the cost is high, search for an optimal dosage is warranted.

© 1989 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Accepted: March 31, 1989
Published online: December 10, 2008
Issue release date: 1989

Number of Print Pages: 8
Number of Figures: 0
Number of Tables: 0

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

For additional information: http://www.karger.com/NEF


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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