Successful treatment with intravenous immunoglobulins in a patient affected by dermatomyositis/systemic lupus erythematosus overlap syndrome and tuberculosis

Luzi, G.; Diamanti, Andrea Picchianti; Germano, V.; Laganà, Bruno; Rosa, Roberta; Salemi, Simonetta; Stoppacciaro, Antonella; D’Amelio, Raffaele

doi:10.1016/j.clim.2007.07.009

Cited by 7 publications

(4 citation statements)

References 15 publications

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“…Intravenous Immunoglobulin could be a safe therapy for the management of active diseases in the setting of TB. 28 Apart from the activation of latent bacilli, de-novo infection could result from an immunosuppressed state. Both SLE and IIM can, at times, have an associated underlying immunodeficiency, more so in children.…”

Section: Discussionmentioning

confidence: 99%

High Prevalence of Active Tuberculosis in Adults and Children with Idiopathic Inflammatory Myositis as Compared with Systemic Lupus Erythematosus in a Tuberculosis Endemic Country: Retrospective Data Review from a Tertiary Care Centre in India

Gupta

Aggarwal

Naveen

et al. 2021

MJR

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Aim: Infections are the leading cause of morbidity and mortality in idiopathic inflammatory myositis (IIM) with India being endemic for Tuberculosis (TB). We compared and contrasted the prevalence, clinical profile and outcomes of active TB in IIM with systemic lupus erythematosus (SLE). Methods: Medical records were reviewed for adults and children with IIM (Bohan and Peter criteria) and SLE (ACR criteria) at a tertiary care hospital in India from January 2015 to October 2017. Follow-up was recorded until February 2020 for all those who had developed active TB. Results: Of 167 (132 adults and 35 juvenile) IIM and 280 (131 adults and 149 juvenile) SLE, active TB occurred in 24 (14.4%) IIM (22 (16.7% of 132) adults; 2 (5.71% of 35) juvenile) and 18 (6.4%) SLE [(8 (6.1% of 131) adults; 10 (6.7% of 149) juvenile, p-value < 0.01]. Patients with IIM had higher odds of developing TB as compared with SLE [OR 2.24 (CI 1.5–5.5), p=0.007]. The risk of developing active TB was 68-fold and 30.4-fold higher in patients with IIM and SLE, respectively, as compared with the general population. Extrapulmonary forms were more common (14/24). Nearly half developed TB during active IIM, at a glucocorticoid dose of 0.25 (0–1.5) mg/kg/day. Over a follow-up duration of 27 months (8–184), all were cured of TB, though prolonged course of anti-tuberculous treatment was required in 25%, and five IIM relapsed during treatment. Conclusion: Patients with IIM have increased risk of active TB, with common extrapulmonary forms, slow response, and relapses during treatment.

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Section: Discussionmentioning

confidence: 99%

High Prevalence of Active Tuberculosis in Adults and Children with Idiopathic Inflammatory Myositis as Compared with Systemic Lupus Erythematosus in a Tuberculosis Endemic Country: Retrospective Data Review from a Tertiary Care Centre in India

Gupta

Aggarwal

Naveen

et al. 2021

MJR

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“…The patients with proximal inflammatory microangiopathy and myopathy, who were refractory to standard immunosuppressive therapy, gained substantial benefits from IVIg at a dose of 2 g/kg per month administered over 2-5 days as second-line therapy [184][185][186][187][188]. SCIg has also been used successfully in the treatment of dermatomyositis [184][185][186][187][188][189].…”

Section: Refractory Dermatomyositis and Polymyositismentioning

confidence: 99%

Indications and safety of intravenous and subcutaneous immunoglobulin therapy

Rezaei

Abolhassani

Aghamohammadi

et al. 2011

Expert Review of Clinical Immunology

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Immunoglobulin (Ig) therapy is an important method of treatment for a number of immunological, hematological, neurological and dermatological disorders. Over the years, the range of indications in which Ig therapy, either replacement or immunomodulatory, is effective has substantially increased. Although Ig therapy was originally limited to intramuscular injection, intravenous infusion has became the most frequent route of administration, followed by subcutaneous injection. This article presents current information on indications, mechanisms of action, efficacy and practical aspects of intravenous and subcutaneous Ig replacement/immunomodulatory therapy as well as associated adverse reactions.

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“…Although there are few studies in the literature, a high prevalence of TB has been described in patients with DM/PM [11]- [38]. In addition, these studies have many limitations: 1) majority are case reports or series [20]- [37]; 2) DM/PM and/or TB diagnosis are based on registration data or the International Classification for Diseases (ICD) [14]- [19]; 3) studies analyzed DM/PM together with other systemic autoimmune diseases [16] [32] [38]; 4) studies evaluated DM/PM associated with other systemic autoimmune diseases (overlap syndromes) or neoplasms [19] [23]; 5) lack of a TB diagnosis definition [16] [17] [18] [19]; 6) control groups are matched for age and gender [17]; 7) studies analyzed TB together with other infectious diseases [11] [12] [15]. Therefore, these factors limit systematic analysis of possible parameters associated with TB in patients with DM/PM.…”

Section: Introductionmentioning

confidence: 99%

Previous Pulmonary Fibrosis in Dermatomyositis/Polymyositis: A Predictive Factor for Pulmonary and Extra-Pulmonary Tuberculosis

Silva¹,

Proença²,

Shinjo³

2018

OJRA

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Successful treatment with intravenous immunoglobulins in a patient affected by dermatomyositis/systemic lupus erythematosus overlap syndrome and tuberculosis

Cited by 7 publications

References 15 publications

High Prevalence of Active Tuberculosis in Adults and Children with Idiopathic Inflammatory Myositis as Compared with Systemic Lupus Erythematosus in a Tuberculosis Endemic Country: Retrospective Data Review from a Tertiary Care Centre in India

High Prevalence of Active Tuberculosis in Adults and Children with Idiopathic Inflammatory Myositis as Compared with Systemic Lupus Erythematosus in a Tuberculosis Endemic Country: Retrospective Data Review from a Tertiary Care Centre in India

Indications and safety of intravenous and subcutaneous immunoglobulin therapy

Previous Pulmonary Fibrosis in Dermatomyositis/Polymyositis: A Predictive Factor for Pulmonary and Extra-Pulmonary Tuberculosis

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