• Rev Med Interne · Mar 2017

    Review Case Reports

    [Off-label use of intravenous immunoglobulin therapy in the treatment of lupus myocarditis: Two case reports and literature review].

    • N Charhon, C Bernard, J C Richard, N Cordel, G Leboucher, C Broussolle, and P Sève.
    • Service pharmaceutique, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France. Electronic address: nicolas.charhon@chu-lyon.fr.
    • Rev Med Interne. 2017 Mar 1; 38 (3): 204-209.

    IntroductionSeveral case reports have reported the benefit of intravenous immunoglobulin therapy in many autoimmune diseases, including systemic lupus erythematosus.Case ReportsHere, we report on two cases of lupus myocarditis treated with high dose of intravenous immunoglobulin. The first patient was a 42-year-old woman who presented with lupus myocarditis that was resistant to corticosteroids and cyclophosphamide, and who was finally successfully treated with a single dose of 2 g/kg of intravenous immunoglobulin. The patient displayed clinical improvement a few days later. The second case - a 43-year-old woman was diagnosed with lupus myocarditis and immunosuppressive drugs were contraindicated because of the context of a recent infective endocarditis. She was treated with repeated dose of 2 g/kg of intravenous immunoglobulin. Clinical improvement was observed and the left ventricular ejection fraction increased from 20 % to 60 % within a few days. We also report 9 similar observations identified from a literature review.ConclusionThe use of intravenous immunoglobulin in lupus myocarditis is not officially recognized but could be considered as an alternative when conventional therapies have failed or are contraindicated.Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

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