Efficacy of early intravenous immunoglobulin for eosinophilic granulomatosis with polyangiitis with drastically progressive neuropathy: A synopsis of two cases

Abstract

Two women, 66-year-old and 63-year-old, were admitted for drastically progressive neuropathy, and diagnosed with eosinophilic granulomatosis with polyangiitis (EGPA). Steroid pulse therapy failed to exert effect upon neuropathy, so we administered early intravenous immunoglobulin (IVIG) for fear of immobilization of neuropathy. This resulted in marked improvement in neuropathy without apparent side effects. Recent evidence suggests the efficacy of IVIG for steroid refractory neuropathy associated with EGPA, but has previously been administered during the chronic phase resulting in slow improvement. Our two successfully treated cases indicate the efficacy of early IVIG in preventing the immobilization of neuropathy, especially in progressive cases. © 2013 The Japanese Society of Internal Medicine.