Objective: Although clearly demonstrated in idiopathic thrombocytopenic purpura, Kawasaki disease, the efficacy of intravenous immunoglobulins in the treatment of rheumatic diseases is still being debated. We investigated the effect of high dose intravenous immunoglobulins in selected rheumatic diseases.

Methods: Twenty nine patients with rheumatic diseases who had received high dose intravenous immunoglobulins were studied. There were 18 patients with systemic lupus erythematosus (SLE), 8 dermatomyositis/polymyositis (DM/PM) patients, 2 adult onset still's disease (AOSD) patients and 1 Henoch-schnlein purpura patient. They were treated with high dose intravenous immunoglobulins (each course consisted of 400 mg/kg for 5 days). Each patient received between 1-37 treatment courses. These patients were evaluated both by clinical outcome and by serologic profile that were taken before and after treatment.

Results: Clinical improvement was observed in 16 patients out of 29 patients. Nine patients of them could decrease daily prednisolone doses. The clinical manifestations that responded good were: skin rash and ulcer, high fever, vasculitis, hemolytic anemia, thrombocytopenia, myositis. However lupus nephritis and interstitial lung disease did not benefit from the treatment.

Conclusion: The high dose intravenous immunoglobulin treatment is good in patients with SLE, DM/PM and AOSD when they are steroid dependent or steroid resistant.

Keywords: Intravenous immunoglobulins, Rheumatic diseases, Systemic lupus erythematosus, Dermatomyositis, Adult onset still's disease