Therapeutical and immunological effects of methylprednisolone pulse therapy in comparison with intravenous immunoglobulin. Treatment in patients with juvenile chronic arthritis.

Twenty patients with polyarticular or systemic subtypes of juvenile chronic arthritis were primary treated with either Methylprednisolone (MP) pulses (group I) or i.v. Immunoglobulin (IG) (group II) in combination with Methotrexat and low dosages of Glucocorticosteroids. Clinical effects of treatment were rapid and excellent in both groups and also the regression of inflammatory activity. MP-pulses and also IG-treatment decrease significant the respective part of lymphocytes and T-cells. Significant is also the decrease of CD4 and CD8 cells and the normalization of the CD4/CD8 ratio in both groups. Different are the effects on B-cells and NK-cells between the two groups. Whereas MP-pulses decrease the number of B-cells. IG-treatment leads to high increase. The number of NK-cells increases after each single MP-pulse and decreases significant after IG-infusions.