Safety and Infectious Prophylaxis of Intravenous Immunoglobulin in Elderly Patients with Membranous Nephropathy

A variety of infections has been recognized as an important cause of morbidity and mortality in patients with nephrotic syndrome, and membranous nephropathy is a common cause of this in the elderly. The reasons for infection risk are due to oedema complications, urinary loss of factor B and D of the...

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Bibliographic Details
Published in:International journal of immunopathology and pharmacology 2014-04, Vol.27 (2), p.305-308
Main Authors: Molinaro, I., Barbano, B., Rosato, E., Cianci, R., Di Mario, F., Quarta, S., Sardo, L., Salsano, F., Amoroso, A., Gigante, A.
Format: Article
Language:English
Subjects:
Age Factors
Aged
Bacterial Infections - microbiology
Bacterial Infections - prevention & control
Drug Administration Schedule
Female
Glomerulonephritis, Membranous - complications
Glomerulonephritis, Membranous - diagnosis
Glomerulonephritis, Membranous - drug therapy
Humans
Immunocompromised Host
Immunoglobulins, Intravenous - administration & dosage
Immunoglobulins, Intravenous - adverse effects
Immunosuppressive Agents - adverse effects
Male
Risk Factors
Treatment Outcome
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Summary:A variety of infections has been recognized as an important cause of morbidity and mortality in patients with nephrotic syndrome, and membranous nephropathy is a common cause of this in the elderly. The reasons for infection risk are due to oedema complications, urinary loss of factor B and D of the alternative complement pathway, cellular immunity, granulocyte chemotaxis, hypogammaglobulinemia with serum IgG levels below 600 mg/dL, and secondary effects of immunosuppressive therapy. Many different prophylactic interventions have been used for reducing the risks of infection in these patients but recommendations for routine use are still lacking. We report two membranous nephropathy cases in the elderly in which Intravenous immunoglobulin were useful in long-term infectious prophylaxis, showing safety in renal function. During immunosuppressant therapy in membranous nephropathy, intravenous immunoglobulin without sucrose are a safe therapeutic option as prophylaxis in those patients with nephrotic syndrome and IgG levels below 600 mg/dL. The long-term goal of infection prevention in these patients is to reduce mortality, prolong survival and improve quality of life.
ISSN:0394-6320
2058-7384
DOI:10.1177/039463201402700220