The role of high-dose intravenous immunoglobulin in rheumatology.

نویسندگان

  • Prashantha M Vaitla
  • Elizabeth M McDermott
چکیده

For many years, non-steroidal anti-inflammatory agents, steroids and immunosuppressive drugs have been the mainstay of treatment for rheumatological disorders. Over the last few years, the emergence of biologic treatments has dramatically changed the management of numerous rheumatological diseases. However, immunoglobulin treatment has been used for decades and its use has still not been superseded in certain rheumatological diseases. In fact, despite the introduction of newer immunomodulatory drugs, there has been an ever-increasing number of clinical indications for which intravenous immunoglobulin (IVIG) has been tried. Immunoglobulins are plasma proteins secreted by plasma cells, forming a major component of the adaptive immune system. IVIG is a blood product prepared from plasma, each batch prepared from a pool of 10,000-20,000 donations. Multiple purification steps during the manufacturing process aim to eliminate all known transmissible pathogens, but cannot completely exclude the risk from unknown pathogens. It should be noted that there has been the transmission of hepatitis C in one batch of immunoglobulin, reported in 1994, resulting in more than 200 patients in the USA and Europe being affected. Nevertheless, IVIG remains relatively safe compared with other immunosuppressive drugs. Headaches and fatigue are common side effects but fortunately the more severe problems such as aseptic meningitis, venous thromboembolism and acute renal failure remain rare. High-dose immunoglobulin when administered i.v. has immunomodulatory properties. The precise mechanism of action of IVIG is complex and not yet fully understood.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Uses of intravenous immunoglobulin

Adjuvant high dose IVIgs are being used increasingly in a range of immune-mediated and auto-immune diseases. Although numerous immunomodulatory mechanisms have been suggested, the exact mechanisms of action are poorly understood. The efficacy of IVIg in certain diseases has been proven in clinical trials, in so far as IVIg is approved as the therapy of choice for Kawasaki syndrome and idiopathi...

متن کامل

Intravenous Immunoglobulin Utilization in a Pediatric Tertiary Care Teaching Hospital in Iran

Intravenous immunoglobulin (IVIG) is an expensive medicine which is widely used for unlabeled indications. We conducted this drug utilization review (DUR) to evaluate the appropriateness of IVIG utilization in Tehran, Iran. This cross sectional study was conducted in a referral pediatric tertiary care hospital in Tehran. During a three month period in 2015, medical records of inpatients with IV...

متن کامل

Intravenous Immunoglobulin Therapy in Medical Praxis

Intravenous immunoglobulin (IVIG) is a blood product prepared from the serum of of a thousand or more blood donors. The IVIG that is available contains complete immunoglobulin G( IgG )molecules which has intact Fc-dependent effector functions. The IgG subclasses match those in normal human serum. It is the main treatment for patients with antibody deficiencies. High dose IVIG (hdIVIG), is used ...

متن کامل

Adverse reactions associated with intravenous immunoglobulin therapy in patients with dermatologic diseases: An 11-year retrospective study

Background: Intravenous immunoglobulin (IVIG) is used to treat many autoimmune and immunodeficiency disorders. The main indications of IVIG in dermatology include treatment for resistant autoimmune bullous diseases, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). Although generally welltolerated, various adverse effects can occur.Methods: We designed a retrospective study ...

متن کامل

Neutropenia Following Intravenous Immunoglobulin Therapy in Pediatric Patients with Idiopathic Thrombocytopenic Purpura

Background: Children with idiopathic thrombocytopenic purpura who are treated with intravenous immunoglobulin therapy might experience a decline in their absolute neutrophil count. The aim of this study was to investigate the incidence of neutropenia following intravenous immunoglobulin therapy in children with idiopathic thrombocytopenic purpura undergoing intravenous immunoglobulin therapy. ...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Rheumatology

دوره 49 6  شماره 

صفحات  -

تاریخ انتشار 2010