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Autoimmune Dis. 2012; 2012: 589359.
Published online 2012 September 27. doi:  10.1155/2012/589359
PMCID: PMC3465901
Intravenous Immunoglobulin in the Management of Lupus Nephritis
Scott E. Wenderfer 1 * and Trisha Thacker 2
1Department of Pediatrics, Renal Section, Baylor College of Medicine, 1102 Bates Street, Suite 260, Houston, TX 77030, USA
2University of Houston, Houston, TX 77004, USA
*Scott E. Wenderfer: wenderfe/at/bcm.edu
Academic Editor: Ricard Cervera
Received May 5, 2012; Revised July 24, 2012; Accepted July 25, 2012.
Abstract
The occurrence of nephritis in patients with systemic lupus erythematosus is associated with increased morbidity and mortality. The pathogenesis of lupus nephritis is complex, involving innate and adaptive cellular and humoral immune responses. Autoantibodies in particular have been shown to be critical in the initiation and progression of renal injury, via interactions with both Fc-receptors and complement. One approach in the management of patients with lupus nephritis has been the use of intravenous immunoglobulin. This therapy has shown benefit in the setting of many forms of autoantibody-mediated injury; however, the mechanisms of efficacy are not fully understood. In this paper, the data supporting the use of immunoglobulin therapy in lupus nephritis will be evaluated. In addition, the potential mechanisms of action will be discussed with respect to the known involvement of complement and Fc-receptors in the kidney parenchyma. Results are provocative and warrant additional clinical trials.
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