Infections in patients with giant cell arteritis: could hypogammaglobulinemia induced by corticosteroids be a risk factor? Comment on the article by Durand and Thomas
Version of Record online: 26 JUN 2012
Copyright © 2012 by the American College of Rheumatology
Arthritis Care & Research
Volume 64, Issue 7, page 1100, July 2012
How to Cite
Fernández-Fernández, F. J. (2012), Infections in patients with giant cell arteritis: could hypogammaglobulinemia induced by corticosteroids be a risk factor? Comment on the article by Durand and Thomas. Arthritis Care Res, 64: 1100. doi: 10.1002/acr.21633
- Issue online: 26 JUN 2012
- Version of Record online: 26 JUN 2012
- Accepted manuscript online: 3 FEB 2012 02:36PM EST
To the Editor:
I read with great interest the article by Durand and Thomas published in a recent issue of Arthritis Care & Research regarding the incidence of infections in patients with giant cell arteritis (GCA) (1). As the authors note, glucocorticoids suppress T cell–mediated cellular immunity and have potent suppressive effects on the effector functions of phagocytes. I recently saw a patient with GCA receiving treatment with corticosteroids. In a routine analysis 6 months after diagnosis, her serum IgG level was low (454 mg/dl). She had no history of hypogammaglobulinemia, and IgG levels were normal 6 months before, when she was diagnosed with GCA. Since the diagnosis of vasculitis, she had several urinary tract infections. While searching for the cause of hypogammaglobulinemia, I found that it could be associated with steroid therapy (2ndash;4). There is disagreement about whether the hypogammaglobulinemia associated with glucocorticoids is associated with a higher prevalence of infections (5) and, to my knowledge, no study has evaluated the effect of glucocorticoids on immunoglobulin levels in patients with GCA.
- 1Incidence of infections in patients with giant cell arteritis: a cohort study. Arthritis Care Res (Hoboken) 2011; 64: 581–8., .
- 2Corticosteroid effect on immunoglobulins. J Allergy Clin Immunol 1978; 62: 162–6., , .
- 3Hypogammaglobulinemia in steroid-dependent asthmatics correlates with the daily dose of oral prednisolone. Int Arch Allergy Immunol 2002; 128: 240–3., , , , , , et al.
- 4Hypogammaglobulinaemia associated with long term, low dose steroid therapy. Postgrad Med J 1985; 61: 523–4., .
- 5Effects of long-term low-dose corticosteroid therapy on humoral immunity. Ann Allergy Asthma Immunol 2006; 97: 113–6., .
Francisco José Fernández-Fernández MD*, * Hospital Arquitecto Marcide, Ferrol, Spain.