Altunrende Burcu, Akdal Gülden, Bajin Meltem Söylev, Yaman Aylin, Kocaslan Meryem, Nalbantoğlu Mecbure, Ertaşoğlu Hülya, Akman Gülsen
Department of Neurology, Bilim University Faculty of Medicine, Istanbul, Turkey.
Department of Neurology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey.
Noro Psikiyatr Ars. 2019 Mar;56(1):3-6. doi: 10.5152/npa.2017.20577. Epub 2018 Nov 28.
Recurrent optic neuritis neuritis (rON) is an autoimmune inflammatory condition of unknown cause. Intravenous immunoglobulin (IVIg) treatment is used for many autoimmune disorders; however we do not have any information about its effect in rON, other than case reports. We aimed to evaluate our patients with rON who were treated with IVIg.
Data from all our patients with rON with or without anti aquaporin4 (AQP4) seropositivity, seen between April 2011 and October 2015, who received IVIg treatment were retrospectively evaluated.
Nine patients (all female) with rON had received IVIg. These patients were aged between 34 and 65 years, and had started receiving monthly IVIg from 6 to 58 months after onset of disease. In three out of nine rON patients serum AQP4 antibody were positive. Under current treatments the patients had continued to have attacks, therefore monthly IVIg was given in addition to the existing immunosuppressant drug. The follow up duration was between 6 to 31 months. Three patients, each suffered one relapse under IVIg treatment. Mean number of relapses in the year prior to treatment was 1.4±0.72, whereas it was 0.3±0.5 during the year after IVIg therapy. During follow-up with IVIg administration only one patient had fever and no other adverse events were reported.
Monthly IVIg is well-tolerated and safe and it seems to be effective in rON as an add on treatment. However, since our study is a retrospective case series, future randomized controlled trials with IVIg are needed.
复发性视神经炎（rON）是一种病因不明的自身免疫性炎症性疾病。静脉注射免疫球蛋白（IVIg）治疗用于多种自身免疫性疾病；然而，除了病例报告外，我们没有关于其对rON疗效的任何信息。我们旨在评估接受IVIg治疗的rON患者。
回顾性评估2011年4月至2015年10月期间我们所有接受IVIg治疗的rON患者的数据，这些患者无论抗水通道蛋白4（AQP4）血清学是否阳性。
9例rON患者（均为女性）接受了IVIg治疗。这些患者年龄在34至65岁之间，在疾病发作后6至58个月开始每月接受IVIg治疗。9例rON患者中有3例血清AQP4抗体呈阳性。在当前治疗下，患者仍有发作，因此在现有免疫抑制药物基础上每月给予IVIg。随访时间为6至31个月。3例患者在IVIg治疗期间各复发1次。治疗前一年的平均复发次数为1.4±0.72，而IVIg治疗后一年为0.3±0.5。在IVIg给药随访期间，仅1例患者出现发热，未报告其他不良事件。
每月IVIg耐受性良好且安全，作为附加治疗似乎对rON有效。然而，由于我们的研究是一项回顾性病例系列研究，未来需要进行IVIg的随机对照试验。
