Efficacy of early intravenous immunoglobulin for eosinophilic granulomatosis with polyangiitis with drastically progressive neuropathy: a synopsis of two cases.

Abstract

Two women, 66-year-old and 63-year-old, were admitted for drastically progressive neuropathy, and diagnosed with eosinophilic granulomatosis with polyangiitis (EGPA). Steroid pulse therapy failed to exert effect upon neuropathy, so we administered early intravenous immunoglobulin (IVIG) for fear of immobilization of neuropathy. This resulted in marked improvement in neuropathy without apparent side effects. Recent evidence suggests the efficacy of IVIG for steroid refractory neuropathy associated with EGPA, but has previously been administered during the chronic phase resulting in slow improvement. Our two successfully treated cases indicate the efficacy of early IVIG in preventing the immobilization of neuropathy, especially in progressive cases.

• Authors: Takeshi Matsumoto, Kojiro Otsuka, Michi Kawamoto, Kazuma Nagata, Ryo Tachikawa, Yukihiro Imai, Nobuyuki Oka, Keisuke Tomii
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 52 Issue 8 Pg. 913-7 ( 2013) ISSN: 1349-7235 [Electronic] Japan
• PMID: 23583996 (Publication Type: Case Reports, Journal Article)

Chemical References

• Immunoglobulins, Intravenous

Topics

• Aged
• Disease Progression
• Eosinophilic Granuloma (complications, diagnosis, drug therapy)
• Female
• Humans
• Immunoglobulins, Intravenous (administration & dosage, therapeutic use)
• Microscopic Polyangiitis (complications, diagnosis, drug therapy)
• Middle Aged
• Neural Conduction (drug effects, physiology)
• Neuralgia (complications, diagnosis, drug therapy)
• Time Factors
• Treatment Outcome