Intravenous immunoglobulin and Sjögren Syndrome
Keywords:
Sjögren Syndrome, Intravenous Immunoglobuline, neuropathyAbstract
Sjögren Syndrome (SS) is an auto-immune disorder with a high
incidence and prevalence, variable clinical manifestations and
well-defined diagnostic criteria. Increasing attention has been devoted to areas like its pathological mechanisms and the search for
new therapeutic strategies. Intravenous immunoglobulin (IVIg) is
indicated for many disorders, and investigation on its mechanisms
of action has yielded some preliminary findings, especially on its
effects on the immune activity. The spectrum for its therapeutic
use, although very controversial, has been increasing, mainly in
situations involving auto-immune processes. There are a few
written cases on the use of IVIg in the SS’s treatment, especially
when neurological manifestations occur. In this paper we review
the interest of using IVIg in SS, and analyze the published case
reports of its use. We find that IVIg seems an important therapeutic option for many cases of SS. Accumulating data suggests a
rational for its use as second line option in cases of extraglandular
manifestations resistant to conventional treatment.
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References
Goldman L, Ausiello D. Cecil Medicine. 23rd edition. Philadelphia: Saunders Elsevier 2008:2041-2045.
Fauci AS et al. Harrison’s principals of internal medicine, 17th ed. New York cGraw-Hill 2008:2107-2109.
Thanou-Stavraki A, James JA. Primary Sjögren Syndrome: Current and Prospective Therapies. Semin Arthritis Rheum 2008; 37(5):273-292.
Wiles CM et al. Intravenous immunoglobulin in neurological disease: a specialist review. J Neurol Nuerosurg Psychiatry 2002:72:440-448.
Fox R. Sjögren’s syndrome. The Lancet 2005;366(9482):321-331.
Casals MR, Carrasco AG, Salazar JR, Alén JC, Franco JF. Enfermedades Autoinmunes sistémicas y reumatológicas. Masson Paris 2005:84-101.
Soliotis FC, Mavragani CP, Moutsopoulos HM. Central nervous system involvement in Sjögren’s syndrome. Ann Rheum Dis 2004; 63:616-620.
Barendregt PJ et al. Involvement of the peripheral nervous system in primary Sjögren’s syndrome. Ann Rheum Dis 2001;60:876-881.
Coppo P et al. Primary Sjögren’s syndrome associated agranulocytosis: a benign disorder? Ann Rheum Dis 2003; 62:476-478.
Royer B et al. Lymphomas in Patients With Sjögren’s Syndrome Are Marginal Zone B-Cell Neoplasms, Arise in Diverse Extranodal and Nodal Sites, and Are Not Associated With Viruses. Blood 1997; 90(2):766-775.
Vitali C et al. Classification criteria for Sjögren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis 2002; 61: 554-558.
Srinivason S, Slomovic AR. Sjögren syndrome. Compr Ophtalmol Update 2007; 8(4):205-212.
Woerkom JM et al. Safety and efficacy of leflunomide in primary Sjögren’s syndrome: a phase two pilot study. BMJ 2007;66:1026-1032.
Furst D E et al. Updated consensus statement on biological agents for the statement on biological agents for the treatment of rheumatic diseases, 2007. Ann Rheum Dis 2007;66:2-22.
Yamada S, Mori K, Matsuo K, Inukai A, Kawagashira Y, Sobue G. Interferon alfa treatment for Sjögren’s syndrome associated neuropathy. J Neurol Neurosurg Psychiatry 2005; 76:576-578.
Cummins MJ, Papas A, Kammer GM, Fox PC. Treatment of primary Sjögren’s syndrome with low dose-human interferon alfa administered by the oromucosal route: Combined phase III results. Arthritis Care and Research 2003 ;49(4):585-593.
Ramos-Casals M; Tzioufas AG; Font J. Primary Sjögren’s syndrome: new clinical and therapeutic concepts. Ann Rheum Dis 2005; 64:347-354.
Imbach P et al. High-dose intravenous gammaglobulin for idiopathic thrombocytopenic purpura in childhood. Lancet 1981;1(8232):1228-1231.
Orange J et al. Use of intravenous immunoglobulin in human disease: A review of evidence by members of the Primary Immunodeficiency Committee of the American Academy of Allergy, Asthma and Immunology. J Allergy Clin Immunol 2006;S525-553.
Jolles S, Sewell WAC, Misbah SA. Clinical uses of intravenous immunoglobulin. Clinical and Experimental Immunology 2005;142:1-11.
Gern JE. Antiinflamatory Activity of IVIG Mediated through the Inhitory FC Receptor. Official Journal of the American Academy of Pediatrics 2002; 110(2) 467-468.
Bleeker WK, Teeling JL, Hack CE. Accelerated autoantibody clearance by intravenous immunoglobulin therapy: studies in experimental models to determine the magnitude and time course of the effect. Blood 2001; 98(10): 3136-3142.
Bayry J, Thirion M, Misra N, Thorenoor N, Delignat S, Lacroix-Desmazes S, Bellon B, Kaveri S, Kazatchkine MD. Mechanisms of action of intravenous immunoglobulin in autoimmune and inflammatory diseases. Neurol Sci. 2003; 24: S217–S221.
Janke AD, Yong VW. Impact of IVIG on the interaction between activated T cells and microglia. Neurological Research 2006; 28(3): 270-274.
Smith AJ et al. Neutralization of Muscarinic Receptor Autoantibodies by Intravenous Immunoglobulin in Sjögren Syndrome. Human Immunology 2005; 66(4): 411-416.
Nimmerjahn F e Ravetch JV. The antiinflamatory activity of IgG: the intravenous IgG paradox. JEM 2007; 204(1) 11-15.
Katz U, Achiron A, Sherer Y, Shoenfeld Y. Safety of intravenous immunoglobulin (IVIG) therapy. Autoimmunity reviews. 2007 Mar; 6(4): 257-259
Elkayam O et al. Acute myocardial infarction associated with high dose intravenous immunoglobulin infusion for autoimmune disorders. A study of four cases. Ann Rheum Dis 2000;59:77.
Kizawa M, Mori K, Iijima M, Koike H, Hattori N, Sobue G. Intravenous immunoglobulin treatment in painful sensory neuropathy without sensory ataxia associated with Sjoögren’s syndrome. J Neurol Neurosurg Psychiatry 2006; 77: 967-969.
Takahashi Y, Takata T, Hoshino M, Sakurai M, Kanazawa I. Benefit of IVIG for long-standing ataxic sensory neuropathy with Sjögren’s syndrome. Neurology 2003; 60:503-505.
Wolfe GI, Nations SP, Burns DK, Herbelin LL, Barohn RJ. Benefit of IVIG for long-standing ataxic sensory neuropathy with Sjogren’s syndrome. Neurology 2003;61:873.
Burns T, Quijano-Roy S, Jones HR. benefit of IVIG for long-standing ataxic sensory neuropathy with Sjögren’s syndrome. Neurology 2003;61:873.
Pascual J, Cid C, Berciano J. High-dose i.v. immunoglobulin for peripheral neuropathy associated with Sjogren’s syndrome. Neurology. 1998;51:650-651.
Levy Y, Uziel Y, Zandman GG, et al. Intravenous immunoglobulins in peripheral neuropathy associated with vasculitis. Ann Rheum Dis 2003;62:1221-1223.
Dupond JL, Gil H, De Waziere B. Five-year efficacy of intravenous gammaglobulin to treat dysautonomia in Sjogren’s syndrome, Am J Med
(1999):125.
Attout H, MArtre A, Guez S, Series C. Syndrome de Sjögren avec épilepsie et dysautonomie. La Revue de Médecine Interne 2005;26(2):141-144.
Taguchi Y et al. High-dose intravenous immunoglobulin in the treatment of sensory ataxic neuropathy with Sjögren’s syndrome: a case report. No To Shinkei 2004;56(5):421-424.
Zeuner RA, Schroeder JO, Schröder, Euler HH. Sucessful application of high dose intravenous immunoglobulins in Sjögren’s syndrome associated arthritis. Ann Rheum Dis 1995; 54: 936.
Amital H et al. Fibrosis regression induced by intravenous gammaglobulin treatment. Ann Rheum Dis 2003;62:175-177
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