Intravenous immunoglobulin

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Intravenous immunoglobulin (IVIG), containing primarily immunoglobulin G, are used to treat a variety of diseases associated with decreased or abnormal immunoglobulin levels. These include pediatric AIDS; primary hypergammaglobulinemia, severe combined immunodeficiency (SCID), neuropathies, cytomegalovirus infections in transplant recipients, chronic lymphocytic leukemia; Kawasaki syndrome, infection in neonates, and idiopathic thrombocytic purpura.

Cytomegalovirus

Cytomegalovirus in transplant patients may be prevented or treated with intravenous immunoglobulins.

Intravenous immunoglobulins may be used for treatment[1][2]; however, it is not clear that either standard immuneglobulin or hyperimmune globulin are effective.[3] Intravenous immunoglobulins may be combined with antiviral drugs.[4][2]

IVIG may be used for prevention in transplantation patients.[5]

Neuropathy

It has been reported to improve quality of life in inflammatory polyneuropathy, especially chronic inflammatory demyelinating polyradiculoneuropathy (. [6] Patient response to IVIG, however, is influenced by a single nucleotide polymorphism in the transient axonal glycoprotein 1 gene (TAG-1)[7] It has also been used in Guillain-Barre syndrome.

References

  1. Waid TH, McKeown JW (1995). "Cytomegalovirus hyperimmune globulin for CMV disease refractory to ganciclovir in renal transplantation.". Transplant Proc 27 (5 Suppl 1): 46. PMID 7482820[e]
  2. 2.0 2.1 Emanuel D, Cunningham I, Jules-Elysee K, Brochstein JA, Kernan NA, Laver J et al. (1988). "Cytomegalovirus pneumonia after bone marrow transplantation successfully treated with the combination of ganciclovir and high-dose intravenous immune globulin.". Ann Intern Med 109 (10): 777-82. PMID 2847609[e]
  3. Ljungman P, Cordonnier C, Einsele H, Bender-Götze C, Bosi A, Dekker A et al. (1998). "Use of intravenous immune globulin in addition to antiviral therapy in the treatment of CMV gastrointestinal disease in allogeneic bone marrow transplant patients: a report from the European Group for Blood and Marrow Transplantation (EBMT). Infectious Diseases Working Party of the EBMT.". Bone Marrow Transplant 21 (5): 473-6. DOI:10.1038/sj.bmt.1701113. PMID 9535039. Research Blogging.
  4. Alexander BT, Hladnik LM, Augustin KM, Casabar E, McKinnon PS, Reichley RM et al. (2010). "Use of cytomegalovirus intravenous immune globulin for the adjunctive treatment of cytomegalovirus in hematopoietic stem cell transplant recipients.". Pharmacotherapy 30 (6): 554-61. DOI:10.1592/phco.30.6.554. PMID 20500045. Research Blogging.
  5. Snydman DR, Werner BG, Heinze-Lacey B, Berardi VP, Tilney NL, Kirkman RL et al. (1987). "Use of cytomegalovirus immune globulin to prevent cytomegalovirus disease in renal-transplant recipients.". N Engl J Med 317 (17): 1049-54. DOI:10.1056/NEJM198710223171703. PMID 2821397. Research Blogging.
  6. Merkies ISJ (14 April 2009), "Immune Globulin Helpful in Polyradiculoneuropathy", Neurology 72: 1337
  7. Sobue G et al., Neurology 2009;73:1348-1352,1344-1345, Immune Globulin Helpful in Polyradiculoneuropathy