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首页> 外文期刊>Journal of the peripheral nervous system : >Drug-induced cutaneous lupus erythematosus after immunoglobulin treatment in chronic inflammatory demyelinating polyneuropathy: a case series
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Drug-induced cutaneous lupus erythematosus after immunoglobulin treatment in chronic inflammatory demyelinating polyneuropathy: a case series

机译：药物引起的皮肤红斑狼疮免疫球蛋白治疗慢性炎症脱髓鞘多神经病:系列

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We describe six patients with cutaneous lupus erythematosus (cLE) during immunoglobulin G (IgG) treatment. Five patients were diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP) and one patient with possible CIDP. Five patients received intravenous immunoglobulin (IVIg) and one patient received subcutaneous immunoglobulin (SCIg). Skin lesions were systematically assessed by a dermatologist including skin biopsies. Patients showed disseminated erythematous plaques on several parts of the body with pre-dominance of the chest and face. Skin biopsies showed perivascular and perifollicular vacuolar inflammation, consistent with the diagnosis of cLE. There were no signs of systemic lupus erythematosus. Anti-SSA (Ro60) antibodies were found in two patients and anti-Ro52 antibodies were detectable in one patient. Symptoms improved in three patients after switching to another brand of IVIg and after use of topical corticosteroids. However, these measures did not lead to a complete resolution of the skin lesions. To achieve complete remission, IgG treatment was ceased in four patients. This led to remission of the skin lesions in two patients and to marked improvement in the other two patients. IVIg had to be restarted in two patients because of a relapse of CIDP which led to worsening of the skin lesions. In one patient with clear IVIg dependency, treatment was continued with addition of topical steroids. In the patient using SCIg, cLE was photosensitive and showed spontaneous remission. The relation of cLE with IgG treatment suggests an immunoglobulin-induced cLE. Only one report previously described the occurrence of IVIg induced cLE in a patient with common variable immunodeficiency.
机译：我们描述六个皮肤红斑狼疮患者狼疮(cLE)在免疫球蛋白G(免疫球蛋白)治疗。慢性炎性脱髓鞘多神经病(CIDP)和一个可能的CIDP患者。患者接受静脉注射免疫球蛋白(丙种球蛋白)和一个病人接受皮下免疫球蛋白(SCIg)。系统地评估皮肤科医生包括皮肤活检。播散性红斑的斑块数的身体部位主要的胸部和脸。perifollicular空泡的炎症,一致蜡烛的诊断。系统性红斑狼疮。在两个病人和抗体被发现anti-Ro52抗体检测在一个病人。切换到另一个品牌的丙种球蛋白使用后的局部皮质类固醇。这些措施并没有导致一个完整的解决皮肤病变。完全缓解,免疫球蛋白治疗停止四个病人。病变2例,显著进步在其他两个病人。在两个病人因为复发的重启CIDP恶化导致的皮肤损伤。在一个病人明确的丙种球蛋白的依赖,治疗是局部的继续增加类固醇。光敏,自发缓解。继续教育的关系与免疫球蛋白治疗建议一个immunoglobulin-induced蜡烛。先前描述的丙种球蛋白的发生诱导患者常见的变量中免疫缺陷。

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