Horneff G, Wahn V
Kinderklinik, Heinrich-Heine-Universität, Düsseldorf, BRD.
Infusionsther Transfusionsmed. 1993 Apr;20 Suppl 1:121-6; discussion 127.
Two children of 9 and 10 years suffering from severe systemic juvenile rheumatoid arthritis were treated intravenously with high-dose human immunoglobulin. Treatment was performed every 4 weeks for 7 and 18 months, respectively. Improvement of arthritic symptoms was demonstrable by significant decreases of Ritchie index and number of swollen joints and the disappearance of heated joints in one patient. The other patient was free of arthritic symptoms since the introduction of immunoglobulin therapy. Clinical symptoms of systemic illness were markedly improved and no relapse was seen. Laboratory parameters also improved, including erythrocyte sedimentation rate, C-reactive protein, hemoglobin, and serum iron levels. Parallel investigations of immunological parameters revealed a decrease of serum Il-1 beta and Il-6 levels and a diminished in vitro production of Il-1 beta, Il-6, and tumor necrosis factor-alpha. Therefore, we suggest a decreased activation status of the monocyte-macrophage system as one possible mode of action.
两名分别为9岁和10岁的患有严重全身型幼年类风湿性关节炎的儿童接受了大剂量静脉注射人免疫球蛋白治疗。治疗分别每4周进行一次，持续7个月和18个月。一名患者的关节炎症状改善表现为里奇指数和肿胀关节数量显著减少以及发热关节消失。另一名患者自采用免疫球蛋白治疗后无关节炎症状。全身疾病的临床症状明显改善且未见复发。实验室参数也有所改善，包括红细胞沉降率、C反应蛋白、血红蛋白和血清铁水平。免疫参数的平行研究显示血清白细胞介素-1β和白细胞介素-6水平降低，白细胞介素-1β、白细胞介素-6和肿瘤坏死因子-α的体外产生减少。因此，我们认为单核细胞-巨噬细胞系统激活状态降低是一种可能的作用方式。
