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High-dose Intravenous Immunoglobulin (high-dose + intravenous_immunoglobulin)

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Medical Sciences100%

Selected Abstracts

Effect of high-dose intravenous immunoglobulin in delayed pressure urticaria

BRITISH JOURNAL OF DERMATOLOGY, Issue 4 2003
G. Dawn
Summary Background Delayed pressure urticaria (DPU) is difficult to treat. High-dose intravenous immunoglobulin (IVIG) has been found to be effective in treating patients with autoimmune chronic urticaria. Objectives To report the effect of IVIG on eight patients with severe unremitting DPU. Methods IVIG was administered at a dose of 2 g kg,1 over 2,3 days on an in-patient basis. The response to treatment was assessed subjectively and recorded as remission, improved or unchanged. An autologous serum skin test (ASST) was performed in seven patients. Results Three of eight patients achieved remission; two after one infusion and one after three infusions. Two patients improved. Three patients remained unchanged; of these, two declined further treatment after two infusions, and one failed to improve after six infusions at monthly intervals. Four of seven patients had positive ASST; three responded to IVIG. Two developed delayed positive ASST; both responded to IVIG. Of three patients with negative ASST, two responded. Conclusions IVIG induced remission or improved symptoms in five of eight patients with DPU with severe unremitting disease who had failed to respond to other therapies or were controlled only with systemic corticosteroids. Those who responded did so with three or fewer infusions. ASST is not a reliable predictor of response to IVIG. [source]

A review of high-dose intravenous immunoglobulin (hdIVIg) in the treatment of the autoimmune blistering disorders

CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 2 2001
S. Jolles
High-dose intravenous immunoglobulin (hdIVIg) is being used increasingly for dermatological indications. Its mode of action is via a number of proposed mechanisms and it is not associated with the many side-effects of steroids and other immunosuppressive agents. The evidence for using hdIVIg in the treatment of autoimmune bullous disorders is based on uncontrolled trials and case reports. However, there are now 62 reported patients and this review aims to make a critical assessment of the current data. This has been obtained from a Medline search of the English literature from 1966 to 2000 for pemphigus vulgaris, pemphigus foliaceus, bullous pemphigoid, pemphigoid gestationis, cicatricial pemphigoid, epidermolysis bullosa acquisita and linear IgA disease. Taken together hdIVIg was effective in 81% of the patients with blistering disease. Patients appear to be more likely to respond when hdIVIg is used as adjunctive therapy (91% response rate) than as monotherapy (56% response rate). hdIVIg may offer a safe potential therapeutic avenue for resistant cases of the autoimmune bullous disorders but should be further assessed using double-blind placebo-controlled trials. [source]

Intravenous immunoglobulins , understanding properties and mechanisms

CLINICAL & EXPERIMENTAL IMMUNOLOGY, Issue 2009
A. Durandy
Summary High-dose intravenous immunoglobulin (IVIg) preparations are used currently for the treatment of autoimmune or inflammatory diseases. Despite numerous studies demonstrating efficacy, the precise mode of action of IVIg remains unclear. Paradoxically, IgG can exert both pro- and anti-inflammatory activities, depending on its concentration. The proinflammatory activity of low-dose IVIg requires complement activation or binding of the Fc fragment of IgG to IgG-specific receptors (Fc,R) on innate immune effector cells. In contrast, when administered in high concentrations, IVIg has anti-inflammatory properties. How this anti-inflammatory effect is mediated has not yet been elucidated fully, and several mutually non-exclusive mechanisms have been proposed. This paper represents the proceedings of a session entitled ,IVIg , Understanding properties and mechanisms' at the 6th International Immunoglobulin Symposium that was held in Interlaken on 26,28 March 2009. The presentations addressed how IgG may affect the cellular compartment, evidence for IVIg-mediated scavenging of complement fragments, the role of the dimeric fraction of IVIg, the anti-inflammatory properties of the minor fraction of sialylated IgG molecules, and the genetic organization and variation in Fc,Rs. These findings demonstrate the considerable progress that has been made in understanding the mechanisms of action of IVIgs, and may influence future perspectives in the field of Ig therapy. [source]

High-dose intravenous immunoglobulin (hdIVIg) in the treatment of autoimmune blistering disorders

CLINICAL & EXPERIMENTAL IMMUNOLOGY, Issue 3 2002
S. JOLLES
First page of article [source]

Multifocal motor neuropathy: Current concepts and controversies,

MUSCLE AND NERVE, Issue 6 2005
Eduardo Nobile-Orazio MD
Abstract Multifocal motor neuropathy (MMN) is now a well-defined purely motor multineuropathy characterized by the presence of multifocal partial motor conduction blocks (CB), frequent association with anti-GM1 IgM antibodies, and usually a good response to high-dose intravenous immunoglobulin (IVIg) therapy. However, several issues remain to be clarified in the diagnosis, pathogenesis, and therapy of this condition including its nosological position and its relation to other chronic dysimmune neuropathies; the degree of CB necessary for the diagnosis of MMN; the existence of an axonal form of MMN; the pathophysiological basis of CB; the pathogenetic role of antiganglioside antibodies; the mechanism of action of IVIg treatments in MMN and the most effective regimen; and the treatment to be used in unresponsive patients. These issues are addressed in this review of the main clinical, electrophysiological, immunological, and therapeutic features of this neuropathy. Muscle Nerve, 2005 [source]

Solar urticaria treated successfully with intravenous high-dose immunoglobulin: a case report

PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE, Issue 6 2008
Isabel Correia
Solar urticaria is an idiopathic, chronic and rare photodermatosis, characterized by the sudden onset of pruritic urticarial hives and plaques on the exposed areas of the skin, after a brief period of exposure to the natural sunlight or to an artificial light source. A Caucasian 27-year-old man presented with clinical features suggestive of solar urticaria was referred to our photodermatology unit, where phototesting confirmed the diagnosis of solar urticaria induced by visible light. As he was refractory to oral antihistamines and had slight improvement under UVA plus visible phototherapy, human high-dose intravenous immunoglobulin was administered, with an excellent clinical-sustained response. [source]

Intravenous immunoglobulin and salicylate differentially modulate pathogenic processes leading to vascular damage in a model of Kawasaki disease

ARTHRITIS & RHEUMATISM, Issue 7 2009
Andrew C. Lau
Objective Kawasaki disease (KD) is a multisystem vasculitis affecting children and is characterized by immune activation in the acute stage of disease. Systemic inflammation eventually subsides, although coronary arteritis persists, resulting in aneurysm formation. KD is the leading cause of acquired heart disease among children in North America. Accepted treatment guidelines include high-dose intravenous immunoglobulin (IVIG) and aspirin in the acute phase. Although this therapy is effective, the cellular and molecular mechanisms involved are not clear. The aim of this study was to examine the effect of IVIG and salicylate at each stage of disease development. Methods Using a murine model of KD, we established and validated several in vitro techniques to reflect 3 key steps involved in disease pathogenesis, as follows: thymidine incorporation to evaluate T cell activation, enzyme-linked immunosorbent assay to measure tumor necrosis factor , (TNF,) production, and real-time polymerase chain reaction to examine TNF,-mediated expression of matrix metalloproteinase 9 (MMP-9). Results At therapeutic concentrations, IVIG, but not salicylate, effectively reduced the immune response leading to TNF, expression. Unexpectedly, pharmacologic doses of salicylate were not able to inhibit TNF, production and in fact enhanced its production. Neither drug directly regulated MMP-9 expression but did so only indirectly via modulating TNF,. TNF, activity was a prerequisite for local expression of MMP-9 at the coronary artery. Conclusion Therapeutic concentrations of IVIG and salicylate differentially modulate the expression of TNF, and its downstream effects. Further dissection of the biologic effects of aspirin in acute KD is necessary for the rational design of therapy. [source]

Clinical-Scientific Notes: Successful pregnancy outcome with the use of antenatal high-dose intravenous immunoglobulin following previous neonatal death associated with neonatal haemochromatosis

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2010
Michael C. NICHOLL
No abstract is available for this article. [source]

Successful treatment of cutaneous lesions in juvenile dermatomyositis with high-dose intravenous immunoglobulin

BRITISH JOURNAL OF DERMATOLOGY, Issue 6 2007
H. Amano
No abstract is available for this article. [source]

Effect of high-dose intravenous immunoglobulin in delayed pressure urticaria

BRITISH JOURNAL OF DERMATOLOGY, Issue 4 2003
G. Dawn
Summary Background Delayed pressure urticaria (DPU) is difficult to treat. High-dose intravenous immunoglobulin (IVIG) has been found to be effective in treating patients with autoimmune chronic urticaria. Objectives To report the effect of IVIG on eight patients with severe unremitting DPU. Methods IVIG was administered at a dose of 2 g kg,1 over 2,3 days on an in-patient basis. The response to treatment was assessed subjectively and recorded as remission, improved or unchanged. An autologous serum skin test (ASST) was performed in seven patients. Results Three of eight patients achieved remission; two after one infusion and one after three infusions. Two patients improved. Three patients remained unchanged; of these, two declined further treatment after two infusions, and one failed to improve after six infusions at monthly intervals. Four of seven patients had positive ASST; three responded to IVIG. Two developed delayed positive ASST; both responded to IVIG. Of three patients with negative ASST, two responded. Conclusions IVIG induced remission or improved symptoms in five of eight patients with DPU with severe unremitting disease who had failed to respond to other therapies or were controlled only with systemic corticosteroids. Those who responded did so with three or fewer infusions. ASST is not a reliable predictor of response to IVIG. [source]

A review of high-dose intravenous immunoglobulin (hdIVIg) in the treatment of the autoimmune blistering disorders

CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 2 2001
S. Jolles
High-dose intravenous immunoglobulin (hdIVIg) is being used increasingly for dermatological indications. Its mode of action is via a number of proposed mechanisms and it is not associated with the many side-effects of steroids and other immunosuppressive agents. The evidence for using hdIVIg in the treatment of autoimmune bullous disorders is based on uncontrolled trials and case reports. However, there are now 62 reported patients and this review aims to make a critical assessment of the current data. This has been obtained from a Medline search of the English literature from 1966 to 2000 for pemphigus vulgaris, pemphigus foliaceus, bullous pemphigoid, pemphigoid gestationis, cicatricial pemphigoid, epidermolysis bullosa acquisita and linear IgA disease. Taken together hdIVIg was effective in 81% of the patients with blistering disease. Patients appear to be more likely to respond when hdIVIg is used as adjunctive therapy (91% response rate) than as monotherapy (56% response rate). hdIVIg may offer a safe potential therapeutic avenue for resistant cases of the autoimmune bullous disorders but should be further assessed using double-blind placebo-controlled trials. [source]