What is the evidence of efficacy of intravenous immunoglobulin (IVIG)?

Updated: Jul 05, 2018
  • Author: Jessica Katz, MD, PhD, FACP; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Answer

Additional investigations include the following:

  • Monoclonal gammopathy-associated systemic capillary-leak syndrome, also known as Clarkson disease, is a rare condition characterized by recurrent life-threatening episodes of capillary hyper-permeability in the context of a monoclonal gammopathy. A study by de Chambrun et al was conducted to better describe the clinical characteristics, natural history, and long-term outcome of monoclonal gammopathy-associated systemic capillary-leak syndrome. Since this condition is unpredictable when life threatening attacks occur, a cohort analysis of 69 patients was performed comparing those who received IVIG (48; 74%) and those that did not in a 5-year period.  Multivariate analysis found preventive treatment with IVIg [hazard ratio (HR) 0.27 (0.10-0.70), p=0.007] and terbutaline [HR 0.35 (0.13-0.96), p=0.041] to be independent predictors of mortality. This study indicated a possible survival benefit in those who received IVIG as a preventive measure. [20]

  • Mori et al (2007) have found that intravenous immunoglobulin therapy does not change the course of Miller Fisher syndrome when used as treatment. [21]

  • Korber et al (2007) have reported successful therapy of scleromyxedema with low-dose intravenous immunoglobulin. [22]

  • Zinman et al (2007), in a randomized trial of 51 patients with myasthenia gravis, found that IVIG had a positive effect in patients with worsening weakness due to myasthenia gravis. [23]

  • Suchak et al (2007) found that intravenous immunoglobulin is effective as a sole immunomodulatory agent for treating pyoderma gangrenosum unresponsive to systemic corticosteroids. [24]

  • Intravenous immunoglobulins are not recommended as a treatment of atopic dermatitis based on published data.

  • Kerr and Ferguson (2007) have noted type II adult-onset pityriasis rubra pilaris successfully treated with intravenous immunoglobulin. [25]

  • In febrile ulceronecrotic pityriasis lichenoides, high-dose IVIG combined with extracorporeal photochemotherapy can be an effective treatment. [26]

  • Peripheral polyneuropathy linked to Churg-Strauss syndrome was improved by 6 rounds of high-dose IVIG. [27]


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