Preliminary results of the efficacy of high-dose intravenous human
IgG in patients with biopsy-confirmed
idiopathic membranous nephropathy (IMGN) were reported. Five patients with normal renal function (
creatinine clearance 125.2 +/- 16 ml/min/1.73 m2 BSA) (Group A) and 4 patients with moderate
renal insufficiency (
creatinine clearance 65.5 +/- 8.3 ml/min/1.73 m2 BSA) (Group B) received pulse doses of
IgG (0.4 g/kg BW) for 3 consecutive days; these 3-day boli were repeated 3 times at 21-day intervals; since then for a 10-month period one bolus once every 3 weeks has been administered. Five responder patients at the end of the trial received a new renal biopsy. In 4 Group A patients complete remission of
proteinuria (daily
proteinuria less than 0.2 g) was observed, whereas 1 patient showed partial remission (
proteinuria 2 g/day). In Group B patients, 1 showed complete remission and 2 partial remission; in 1 patient no variation of
proteinuria was noted. In responder patients clinical and
biological findings of the
nephrotic syndrome disappeared and a statistically significant increase of
creatinine clearance was observed. In control biopsies at the end of the trial the immunofluorescence staining failed to find immunodeposits and recovery of glomerular lesions at light microscopy. In conclusion,
IgG therapy seems to be of benefit to patients with IMGN but a randomized clinical trial to confirm this preliminary report is needed.