Immunoglobulin abnormalities are frequent in patients with lupus nephritis
Identifieur interne : 000749 ( Main/Exploration ); précédent : 000748; suivant : 000750Immunoglobulin abnormalities are frequent in patients with lupus nephritis
Auteurs : M. J. Cuadrado [Royaume-Uni] ; I. Calatayud [Royaume-Uni] ; M. Urquizu-Padilla [Royaume-Uni] ; S. Wijetilleka [Royaume-Uni] ; S. Kiani-Alikhan [Royaume-Uni] ; M. Y. Karim [Qatar]Source :
- BMC Rheumatology [ 2520-1026 ] ; 2019.
Abstract
Hypogammaglobulinemia is a complication of B-cell targeting therapies (BCTT), used in vasculitis, rheumatoid arthritis and systemic lupus erythematosus (SLE). Since autoimmune diseases are associated with underlying and induced immune abnormalities, several societies recommend assessing immune function before and during rituximab treatment. In SLE, polyclonal hypergammaglobulinemia is the typical alteration of gammaglobulins, though hypogammaglobulinemia has also been reported.
This is a cross-sectional study describing immunoglobulin levels measured as part of routine care in patients with lupus nephritis, a group with multiple factors contributing to immunoglobulin abnormalities, including immune dysregulation, immunosuppression and nephrotic syndrome.
Polyclonal hypergammaglobulinemia occurred in 15/83 (18.1%) patients. In contrast, low levels of immunoglobulins were found as follows: selective IgA deficiency 2/83 (2.4%), reduced IgG levels 7/83 (8.4%), reduced IgM 14/83 (16.9%). Only 1 patient required immunoglobulin replacement.
Immunoglobulin abnormalities are frequently found in lupus nephritis, ranging from polyclonal hypergammaglobulinemia to hypogammglobulinemia. Consequently, immunoglobulin levels should be assessed prior to commencing BCTT.
Url:
DOI: 10.1186/s41927-019-0079-2
PubMed: 31453435
PubMed Central: 6702722
Affiliations:
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Urquizu-Padilla</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Louise Coote Lupus Unit, Guy’s & St Thomas’ Hospitals, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Louise Coote Lupus Unit, Guy’s & St Thomas’ Hospitals, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Wijetilleka, S" sort="Wijetilleka, S" uniqKey="Wijetilleka S" first="S." last="Wijetilleka">S. 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J." last="Cuadrado">M. J. Cuadrado</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Louise Coote Lupus Unit, Guy’s & St Thomas’ Hospitals, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Louise Coote Lupus Unit, Guy’s & St Thomas’ Hospitals, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Calatayud, I" sort="Calatayud, I" uniqKey="Calatayud I" first="I." last="Calatayud">I. Calatayud</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Louise Coote Lupus Unit, Guy’s & St Thomas’ Hospitals, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Louise Coote Lupus Unit, Guy’s & St Thomas’ Hospitals, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Urquizu Padilla, M" sort="Urquizu Padilla, M" uniqKey="Urquizu Padilla M" first="M." last="Urquizu-Padilla">M. 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Karim</name><affiliation wicri:level="1"><nlm:aff id="Aff4">Dept of Pathology, Sidra Medicine, Doha, Qatar</nlm:aff><country xml:lang="fr">Qatar</country><wicri:regionArea>Dept of Pathology, Sidra Medicine, Doha</wicri:regionArea><wicri:noRegion>Doha</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Rheumatology</title><idno type="eISSN">2520-1026</idno><imprint><date when="2019">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p id="Par1">Hypogammaglobulinemia is a complication of B-cell targeting therapies (BCTT), used in vasculitis, rheumatoid arthritis and systemic lupus erythematosus (SLE). Since autoimmune diseases are associated with underlying and induced immune abnormalities, several societies recommend assessing immune function before and during rituximab treatment. In SLE, polyclonal hypergammaglobulinemia is the typical alteration of gammaglobulins, though hypogammaglobulinemia has also been reported.</p></sec><sec><title>Methods</title><p id="Par2">This is a cross-sectional study describing immunoglobulin levels measured as part of routine care in patients with lupus nephritis, a group with multiple factors contributing to immunoglobulin abnormalities, including immune dysregulation, immunosuppression and nephrotic syndrome.</p></sec><sec><title>Results</title><p id="Par3">Polyclonal hypergammaglobulinemia occurred in 15/83 (18.1%) patients. In contrast, low levels of immunoglobulins were found as follows: selective IgA deficiency 2/83 (2.4%), reduced IgG levels 7/83 (8.4%), reduced IgM 14/83 (16.9%). Only 1 patient required immunoglobulin replacement.</p></sec><sec><title>Conclusions</title><p id="Par4">Immunoglobulin abnormalities are frequently found in lupus nephritis, ranging from polyclonal hypergammaglobulinemia to hypogammglobulinemia. 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