IMMUNE MODULATING EFFECTS OF GAMMA-GLOBULIN IN A PATIENT WITH AN OVERLAPPING SYNDROME

We report a 46 years old woman with a diagnosis of systemic lupus eryt hematosus and scleroderma overlapping syndrome. During treatment with steroids and azathioprine, the appearance of paresthesias and a progre ssive invalidating proximal weakness runs interpreted ns a steroidal m yopathy. Steroidal treatment was progressively discontinued, but lupic activity and esophageal involvement exacerbated. Therefore, the use o f Immune modulating doses of intravenous gamma globulin (2 g/kg/total dose) was decided. The patient received this dose in two consecutive d ays and, 48 hours later, a notable improvement in esophageal function and general condition was verified. After six months of follow up,. th e disease remains inactive.