Intravenous immunoglobulin treatment of lupus nephritis

Semin Arthritis Rheum. 2000 Apr;29(5):321-7. doi: 10.1016/s0049-0172(00)80018-9.


Objective: To evaluate the clinical response of treatment-resistant membranous and membranoproliferative lupus nephritis to intravenous immunoglobulin (IVIg).

Methods: Seven lupus nephritis patients who failed to respond to at least prednisone and cyclophosphamide were studied. A kidney biopsy showing either membranous or membranoproliferative glomerulonephritis was available in six patients. They were treated with six courses (patients 1 and 2) or 1 or 2 courses (patients 3 through 7) of high-dose IVIg. For patients 3 through 7, the plasma levels of albumin, total cholesterol, urea, creatinine, dsDNA antibody titers, and daily proteinuria were measured just before the IVIg therapy, immediately on completion, and 6 months later.

Results: All seven patients had a beneficial response to IVIg. In patient 1, decrease in proteinuria was evident 2 weeks after IVIg was started, nephrotic syndrome gradually disappeared, and she had no proteinuria in 3 years' follow-up. Decline in proteinuria was evident in patient 2 after the 4th IVIg course, but proteinuria reached the pretreatment level 4 months after the therapy ended. In patients 3 through 7, the mean daily proteinuria before IVIg (5.3 +/- 2.1 g) decreased after 1 or 2 IVIg courses (3.3 +/- 1.4 g), and further decreased when measured 6 months later (2.1 +/- 1.3 g). Similarly, the plasma cholesterol level decreased while the plasma albumin level increased after IVIg.

Conclusions: IVIg might be effective in treatment-resistant membranous or membranoproliferative lupus nephritis. Future studies should concentrate on determining the preferred treatment protocol of IVIg for the various classes of lupus nephritis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Biomarkers / blood
  • Cyclophosphamide / therapeutic use
  • Drug Resistance
  • Female
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use*
  • Kidney Function Tests
  • Lupus Nephritis / blood
  • Lupus Nephritis / drug therapy*
  • Male
  • Middle Aged
  • Nephrotic Syndrome / blood
  • Nephrotic Syndrome / drug therapy
  • Prednisone / therapeutic use
  • Proteinuria / blood
  • Proteinuria / drug therapy
  • Treatment Outcome


  • Biomarkers
  • Immunoglobulins, Intravenous
  • Cyclophosphamide
  • Prednisone