Management of hypogammaglobulinaemia occurring in patients with systemic lupus erythematosus

Objectives. Systemic lupus erythematosus (SLE) is typically associated with hypergammaglobulinaemia but has been described in the setting of hypogammaglobulinaemia as well. The purpose of this article is to describe various cases of SLE and hypogammaglobulinaemia, review the literature and present m...

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Bibliographic Details
Published in:Rheumatology (Oxford, England) England), 2008-09, Vol.47 (9), p.1400-1405
Main Authors: Yong, P. F. K., Aslam, L., Karim, M. Y., Khamashta, M. A.
Format: Article
Language:English
Subjects:
Adult
Agammaglobulinemia - etiology
Agammaglobulinemia - therapy
Aged
Anti-Bacterial Agents - therapeutic use
Biological and medical sciences
Common Variable Immunodeficiency - etiology
Diseases of the osteoarticular system
Female
Humans
Hypogammaglobulinaemia
IgA Deficiency - etiology
Immunodeficiencies
Immunodeficiencies. Immunoglobulinopathies
Immunodeficiency
Immunoglobulin G
Immunoglobulin M - deficiency
Immunoglobulins - blood
Immunoglobulins, Intravenous - therapeutic use
Immunopathology
Lupus Erythematosus, Systemic - complications
Lupus Nephritis - complications
Male
Medical sciences
Nephrotic Syndrome - immunology
Opportunistic Infections - complications
Opportunistic Infections - drug therapy
Primary antibody deficiency
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Systemic lupus erythematosus
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Summary:Objectives. Systemic lupus erythematosus (SLE) is typically associated with hypergammaglobulinaemia but has been described in the setting of hypogammaglobulinaemia as well. The purpose of this article is to describe various cases of SLE and hypogammaglobulinaemia, review the literature and present management strategies for hypogammaglobulinaemia in SLE. Methods. We describe five patients with SLE and antibody deficiency, and review the literature exploring the relationship between the two. Results. Various types of antibody deficiency syndromes, including common variable immunodeficiency (CVID), IgA deficiency, IgM deficiency, drug-induced hypogammaglobulinaemia and hypogammaglobulinaemia secondary to nephrotic syndrome can occur in SLE. Antibody deficiency states can be treated with antibiotics and replacement immunoglobulin therapy (particularly CVID) but sometimes close monitoring is all that is required. Conclusion. Measurement of immunoglobulin levels is useful in SLE to identify coexisting antibody deficiency and the later development of hypogammaglobulinaemia. This allows monitoring and appropriate treatment to be instituted.
ISSN:1462-0324
1462-0332
DOI:10.1093/rheumatology/ken255