Off-label use of intravenous immunoglobulin therapy in the treatment of lupus myocarditis: Two case reports and literature review. Utilisation hors AMM d’immunoglobulines intraveineuses dans le traitement de la myocardite lupique : à propos de deux cas et revue de la littérature

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Charhon, N. | Bernard, C. | Richard, J.C. | Cordel, N. | Leboucher, G. | Broussolle, C. | Seve, P.

Edité par CCSD ; Elsevier -

International audience. INTRODUCTION: Several case reports have reported the benefit of intravenous immunoglobulin therapy in many autoimmune diseases, including systemic lupus erythematosus. CASE REPORTS: Here, 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. CONCLUSION: The 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

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