USE OF INTRAVENOUS IMMUNOGLOBULINS IN CHILDREN WITH RHEUMATIC DISEASES

Objective. To evaluate the IVIGs effectiveness in children with juvenile idiopathic arthritis (JIA), juvenile scleroderma (JS), and systemic lupus erythematosus (SLE).

Materials and methods. Immunological studies were carried out on the base of the rheumatologic department of the 4th Minsk City Clinical Hospital for Children and the research laboratory of Belarus Medical Academy for Postgraduate Training (BelMAPT). The study enrolled 212 children suffering from rheumatic diseases (JIA, JS, SLE) including 66 boys and 146 girls. The serum tumor necrosis factor alpha concentration was determined by enzyme immunoassay using Immunotech (France) in the radioisotope group of the BelMAPT. The data obtained was processed statistically using the traditional methods of the variation statistics using STATISTICA 8.0.

Results. The сhildren with rheumatic diseases (JIA, JS or SLE) were found to have impaired immunological mechanisms of the immune response regulation involving CD4+ and CD8+ cells, the B-lymphocytes and hyperproduction of IgG, IgM and TNF-a activation their severity depending on the degree of activity of the inflammatory process. The virologic examination revealed presence of IgM and/or IgG antibodies to herpes simplex virus types 1 and 2 in 76 (57.7%) children with JIA, in 17 (42.5%) children with JS, and in 8 (32%) children with SLE, to Epstein — Barr virus — in 68 (46.3%) children with JIA, in 14 (35%) children with JS, and in 12 (48%) children with SLE, to cytomegalovirus — in 57 (38.7%) children with JIA, in 10 (25%) children with JS, and in 9 (36%) children with SLE.

Conclusion. Those changes in the immune status of children with rheumatic diseases characterized by the imbalanced immunoregulatory subpopulations of T-lymphocytes, imbalanced cytokines with pro-inflammatory functions in combination with persistent viral infection serve the basis for carrying out the IVIG immunocorrective therapy, a safe and effective means of the rheumatic diseases complex therapy.

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Автор(ы): I. D. Chyzheuskaya