HIGH-DOSE IMMUNOGLOBULIN THERAPY OF RHEUM ATOID-ARTHRITIS

Eight patients suffering from severe rheumatoid arthritis were treated with high-dose human immunoglobulin. Doses of 500 mg/kg were administ ered intravenously in the morning on 4 consecutive days. Improvement o f arthritic symptoms was indicated by a significant decrease of the Ri tchie index, the number of swollen joints, and the duration of morning stiffness as well as an increase of grip strength. The improvement la sted up to 4 months. In 2 patients the disease activity increased agai n after 4 weeks. Investigations of laboratory parameters demonstrated a significant reduction of the acute-phase response. Parallel investig ations of immunological parameters revealed a decrease of Il-6 levels in the sera. Therefore, we suggest a decreased activation status of th e monocyte-macrophage system and T cells as a possible mode of action of high-dose immunoglobulin therapy in rheumatoid arthritis.