Immunoglobulin abnormalities are frequent in patients with lupus nephritis
Identifieur interne : 000693 ( Pmc/Checkpoint ); précédent : 000692; suivant : 000694Immunoglobulin 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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PMC:6702722Le document en format XML
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<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. Consequently, immunoglobulin levels should be assessed prior to commencing BCTT.</p>
</sec>
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<title-group><article-title>Immunoglobulin abnormalities are frequent in patients with lupus nephritis</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Cuadrado</surname>
<given-names>M. J.</given-names>
</name>
<address><email>mjcuadrado@yahoo.com</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Calatayud</surname>
<given-names>I.</given-names>
</name>
<address><email>irecalata@hotmail.com</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Urquizu-Padilla</surname>
<given-names>M.</given-names>
</name>
<address><email>mariaurquizu@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Wijetilleka</surname>
<given-names>S.</given-names>
</name>
<address><email>sonaliwijetilleka@doctors.org.uk</email>
</address>
<xref ref-type="aff" rid="Aff2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kiani-Alikhan</surname>
<given-names>S.</given-names>
</name>
<address><email>skiani@nhs.net</email>
</address>
<xref ref-type="aff" rid="Aff3">3</xref>
</contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Karim</surname>
<given-names>M. Y.</given-names>
</name>
<address><phone>+974 77946782</phone>
<email>mkarim@sidra.org</email>
</address>
<xref ref-type="aff" rid="Aff4">4</xref>
</contrib>
<aff id="Aff1"><label>1</label>
Louise Coote Lupus Unit, Guy’s & St Thomas’ Hospitals, London, UK</aff>
<aff id="Aff2"><label>2</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0169 7725</institution-id>
<institution-id institution-id-type="GRID">grid.241103.5</institution-id>
<institution>Dept of Immunology,</institution>
<institution>University Hospital Wales,</institution>
</institution-wrap>
Cardiff, UK</aff>
<aff id="Aff3"><label>3</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 0372 5777</institution-id>
<institution-id institution-id-type="GRID">grid.139534.9</institution-id>
<institution>Dept of Immunology,</institution>
<institution>Barts Health NHS Trust,</institution>
</institution-wrap>
London, UK</aff>
<aff id="Aff4"><label>4</label>
Dept of Pathology, Sidra Medicine, Doha, Qatar</aff>
</contrib-group>
<pub-date pub-type="epub"><day>21</day>
<month>8</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>21</day>
<month>8</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="collection"><year>2019</year>
</pub-date>
<volume>3</volume>
<elocation-id>30</elocation-id>
<history><date date-type="received"><day>9</day>
<month>4</month>
<year>2019</year>
</date>
<date date-type="accepted"><day>24</day>
<month>7</month>
<year>2019</year>
</date>
</history>
<permissions><copyright-statement>© The Author(s) 2019</copyright-statement>
<license license-type="OpenAccess"><license-p><bold>Open Access</bold>
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>
) applies to the data made available in this article, unless otherwise stated.</license-p>
</license>
</permissions>
<abstract id="Abs1"><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. Consequently, immunoglobulin levels should be assessed prior to commencing BCTT.</p>
</sec>
</abstract>
<kwd-group xml:lang="en"><title>Keywords</title>
<kwd>Immunoglobulins</kwd>
<kwd>SLE</kwd>
<kwd>Lupus nephritis</kwd>
<kwd>Hypogammaglobulinemia</kwd>
<kwd>Rituximab</kwd>
<kwd>Autoimmune</kwd>
<kwd>B-cells</kwd>
</kwd-group>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© The Author(s) 2019</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Qatar</li>
<li>Royaume-Uni</li>
</country>
<region><li>Angleterre</li>
<li>Grand Londres</li>
</region>
<settlement><li>Londres</li>
</settlement>
</list>
<tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Cuadrado, M J" sort="Cuadrado, M J" uniqKey="Cuadrado M" first="M. J." last="Cuadrado">M. J. Cuadrado</name>
</region>
<name sortKey="Calatayud, I" sort="Calatayud, I" uniqKey="Calatayud I" first="I." last="Calatayud">I. Calatayud</name>
<name sortKey="Kiani Alikhan, S" sort="Kiani Alikhan, S" uniqKey="Kiani Alikhan S" first="S." last="Kiani-Alikhan">S. Kiani-Alikhan</name>
<name sortKey="Urquizu Padilla, M" sort="Urquizu Padilla, M" uniqKey="Urquizu Padilla M" first="M." last="Urquizu-Padilla">M. Urquizu-Padilla</name>
<name sortKey="Wijetilleka, S" sort="Wijetilleka, S" uniqKey="Wijetilleka S" first="S." last="Wijetilleka">S. Wijetilleka</name>
</country>
<country name="Qatar"><noRegion><name sortKey="Karim, M Y" sort="Karim, M Y" uniqKey="Karim M" first="M. Y." last="Karim">M. Y. Karim</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>
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