Le immunoglobuline nella terapia delle malattie reumatiche : descrizione di un caso di vasculite cutanea e revisione della letteratura

Intravenous immunoglobulins (IVIG) have become an important therapeutic tool not only for patients with idiopathic and acquired immunodeficiencies, but also in a number of immunorheumatic conditions. The mechanisms by which IVIG exert their immunoregulatory effects are not completely defined and probably differ in the various diseases. Although generally well tolerated, since severe side-effects can occur, patients at risk (IgA deficient patients, older patients, patients with kidney or heart disease) must be identified to minimize adverse events. At present, ANCA-associated vasculitis, dermatomyositis and probably fibrosing conditions may represent the rheumatic diseases for which IVIG efficacy seems to be well documented. Controlled trials are however needed to provide guidelines for IVIG use in rheumatic diseases.