What is the role for intravenous immunoglobulin in treating vasculitis?

Intravenous immunologlobulin (IVIG) is not often used to treat vasculitis. IVIG is the purified antibody-containing part of the blood proteins obtained from blood donations. IVIG is most often used in treating vasculitis when a patient with active vasculitis also has an infection. Unlike most other treatments used in treating vasculitis,…...

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How long can a patient stay on Methotrexate?

Many patients with rheumatoid arthritis have stayed on this drug for 20 years or more. It used to be recommended that every patient who reached a certain lifetime dose of methotrexate receive a liver biopsy, but that is no longer recommended by rheumatology organizations as long as blood tests related…...

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Does Cytoxan usage increase possibility of infection? What should a patient look for? CBC? WBC? RBC?

Yes. The risk of infection is higher when the WBC count is low, but patients with normal WBC counts are still at increased risk, and not everyone with a low WBC count (less than 3-4) gets infections. Usually the dose of Cytoxan is reduced when the WBC count falls below…...

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What are the long-term side effects of cyclophosphamide use?

The long-term side effects of cyclophosphamide (Cytoxan) are damage to the bladder and the bone marrow. Bladder cancer is a well-known risk and continues to arise at least 10-15 years after the drug was given. Periodic urinalysis is considered a good screen, such that a normal urinalysis is very reassuring;…...

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Please discuss reasonable precautions to take to prevent infections when immunosuppressed.

Patients immunosuppressed due to treatment for vasculitis do not need to take extraordinary precautions to avoid infection, the way patients with severe AIDS or recent bone-marrow transplants do. Participation in employment and recreational activities are strongly encouraged. It is probably wise to avoid undercooked meat and a few very specific…...

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