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Objectives Systemic Lupus Erythematosus/SLE/is chronic autoimmune disease characterized by heterogeneous, multisystem involvment and the production of variety of antibodies. Infections remain a significant source of morbidity and mortality in SLE. The underlying disease processes and therapeutic immunosuppression can increase susceptability to different type of pathogenes.SLE carried the greatest risk of active tuberculosis and the lymphopenia, cumulative gluccorticoide dose, the use of two or more immunosupressant are associated wiht risk of infection. Intravenous immunoglobulins (IVIg) are used as a replacement treatment for immunodeficiency conditions occurring with humoral or combined immunodeficiency and as immunomodulatory therapy for various autoimmune inflammatory diseases. In a number of rheumatic diseases, IVIg is used off-label, but with great success. These are Systemic Lupus Erythematosus, Progressive SystemicSclerosis, Antiphospholipid syndrome, a number of vasculitis and thrombocytopenia, secondary immunodeficiency. The mechanism of action of IVIg in Systemic connective tissue diseases involves an idiotypic-anti-idiotype interaction between anti-idiotypic antibodies in IVIG and antibodies directed against dsDNA, factor VIII, ANCA, in which anti-idiotypic networks are formed. The anti-idiotypic antibodies in IVIG activate the inhibitory FcyRIIb, leading to off-signaling on B cells and suppression of autoantibody production.Methods We present the case of a 38-year-old female patient, diagnosed with SLE - cutaneous, joint form with immunological activity, Lupus nephritis. She was treated with Methylprednisolone, Hydroxychloroquine, Azathioprine, one infusion of Belimumab. After 18 month evolution of SLE, with manifestation of pulmonary tuberculosis on the background of immunosuppressive therapy. Triple tuberculostatic therapy - Isoniasid, Rifampicin, Ethambutol hydrochloride and Intravenous Immunoglobulin infusions were performed with a good therapeutic response. Intravenous immunoglobulin products (IVIg) 15 g per infusion were applied for 12 consecutive months.Results As a result of the treatment, the general condition of the patient significantly improved, the inflammatory markers normalized. To date, there has been no new surge in Lupus nephritis activity and massive proteinuria.Conclusions Aggressive immunomodulation with glucocorticosteroids and cytotoxic drugs has improved the overall survival of SLE patients, but it creates a relative immunodeficient condition that increases the risk of serious infections. Hydroxychloroquine may decrease the risk of infection in SLE patients.