6533b85ffe1ef96bd12c245a
RESEARCH PRODUCT
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Susanne ModrowEsther Müller-godeffroyPhilipp Von LandenbergHartwig W. LehmannAnnelie Plentzsubject
medicine.medical_specialtyOligoarthritisbiologyParvovirusbusiness.industryPolyarticular Arthritisbiology.organism_classificationmedicine.diseaseRheumatologyRheumatologyQuality of lifeInternal medicineImmunologybiology.proteinmedicinePolyarthritisAntibodybusinessViral loaddescription
Children with rheumatic oligoarthritis and polyarthritis frequently establish persistent parvovirus B19 infections that may be associated with the production of antiphospholipid antibodies (anti-PL IgG). In this study we analysed the influence of high-dose intravenous immunoglobulin (IVIG) therapy on virus load, on the level of anti-PL IgG and its potential capacity to improve the patients' clinical status. Four juvenile patients with long-lasting polyarticular rheumatic diseases and persistent parvovirus B19 infection, associated in three cases with the presence of antibodies against β2-glycoprotein I (anti-β2GPI IgG), were treated with two cycles of IVIG on five successive days (0.4 g/kg per day). Clinical parameters including scores of disease activity, virus load and anti-PL IgG levels were determined before, during and after treatment. Two patients showed a complete remission that has lasted 15 months. During that period they showed neither clinical nor laboratory signs of inflammation. Viral DNA was not detectable in serum, and a decrease in anti-β2GPI IgG was observed. As assessed by the Childhood Health Assessment Questionnaire and the Health-related Quality of Life Questionnaire for Children, both patients were no longer restricted in their activities of daily living and no impact on the health-related quality of life was observed. In one patient the therapy failed: there was no improvement of symptoms and no decrease in virus load or inflammatory parameters. In the fourth patient, clinical and laboratory parameters did not improve despite a decrease in both viral load and anti-PL IgG. Our results show that the use of IVIG to treat parvovirus B19-triggered polyarticular rheumatic disease of childhood might offer an opportunity to improve this disabling condition.
year | journal | country | edition | language |
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2004-01-01 | Arthritis Research & Therapy |