scholarly journals A Retrospective Observational Study of Adverse Reactions Associated With Intravenous Immunoglobulin Infusion

2021 ◽  
Vol 12 ◽  
Author(s):  
Hidefumi Kato ◽  
Megumi Hayashi ◽  
Wataru Ohashi ◽  
Takamasa Yamaguchi ◽  
Satomi Tanaka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intravenous Immunoglobulin ◽  
Neuromuscular Disease ◽  
Adverse Reactions ◽  
Ivig Therapy ◽  
High Dose ◽  
Adult Age ◽  
Patient Demographics ◽  
Dosing Regimens ◽  
Design And Methods

BackgroundAlthough intravenous immunoglobulin (IVIG) therapy is generally safe and well tolerated, adverse reactions (ARs) do occur. The majority of these ARs are mild and transient. Risk factors for ARs associate with IVIG infusions are not well established. This study investigated possible risk factors influencing the occurrence of IVIG-associated ARs.Study Design and MethodsThis was a retrospective observational analysis of data accumulated over 5 years, including patient demographics, clinical condition, IVIG dosing regimens, number of IVIG infusions, and any ARs.ResultsARs were associated with IVIG in 4.9% of patients and 2.5% of infusions. By univariate analyses, ARs correlated with female sex, adult age, high dose IVIG, and autoimmune disease. Multivariate logistic regression identified three statistically significant of risk factors: on a per-patient basis, being female (p=0.0018), having neuromuscular disease (p=0.0002), and receiving higher doses of IVIG per patient body weight (p<0.001), on a per-infusion basis, being female (p < 0.001), being adolescents to middle age (p < 0.001), and having neuromuscular disease (p < 0.001).ConclusionNeuromuscular disease emerged as one of the significant factors for ARs to IVIG.

scholarly journals High-dose intravenous immunoglobulin therapy induces and maintains complete remission for polyarteritis nodosa

2014 ◽  
Vol 1 (1) ◽  
pp. 13
Author(s):  
Kazu Ode ◽  
Yoshinori Taniguchi ◽  
Yoshitaka Kumon ◽  
Yoshio Terada
Keyword(s):  
Complete Remission ◽  
Intravenous Immunoglobulin ◽  
Polyarteritis Nodosa ◽  
Alternative Therapy ◽  
Ivig Therapy ◽  
Immunoglobulin Therapy ◽  
High Dose ◽  
Intravenous Immunoglobulin Therapy ◽  
First Line Therapy ◽  
High Dose Ivig

We report a case of successful high-dose intravenous immunoglobulin (IVIG) use in a patient with refractory polyarteritis nodosa (PAN). Treatments with prednisolone (PSL) and various types of immunosuppressants including methotrexate (MTX) and intravenous cyclophosphamide (IVCY) were unsuccessful, and then, high-dose IVIG therapy was added. High-dose IVIG therapy improved all symptoms including high fever, arthralgia, mononeuritis multiplex and indurated erythema due to PAN. Moreover, serum inflammatory markers were also normalized. High-dose IVIG is maintaining complete remission for PAN without flare-up for additional 4 years. Therefore, high-dose IVIG therapy might be considered as a first-line therapy in patients with PAN or alternative therapy in refractory PAN.

scholarly journals The Use Of Intravenous Immunoglobulin For The Treatment Of Severe Covid-19: Case Presentation For Three Patients

2021 ◽  
Author(s):  
Nuh Kumru ◽  
Saliha Yarımoğlu ◽  
Tayfun Et ◽  
Rafet Yarımoğlu ◽  
Muhammet Korkusuz
Keyword(s):  
Intravenous Immunoglobulin ◽  
Ivig Therapy ◽  
High Dose ◽  
Case Presentation ◽  
Receptor Blockers ◽  
Interleukin Receptor

Although the treatment of the hyperinflammatory response due to COVID-19 has not yet been found, high-dose corticosteroids, interleukin receptor blockers and intravenous immunoglobulin (IVIG) are used to improve the hyperinflammatory response.In this article, we aimed to share our experiences with 3 patients who received IVIG therapy in ICU.

scholarly journals Excellent response to high-dose intravenous immunoglobulin in anti-PF4 positive cerebral thrombosis following Ofxord-AstraZeneca AZD1222 vaccine

2021 ◽  
Author(s):  
Carla Zanferrari ◽  
Simona Fanucchi ◽  
Nicola L. Liberato ◽  
Giuseppe Lauria ◽  
Alessandra Persico ◽  
...  
Keyword(s):  
Platelet Count ◽  
Intravenous Immunoglobulin ◽  
Clinical Picture ◽  
Ivig Therapy ◽  
High Dose ◽  
Platelet Factor ◽  
Normal Value ◽  
Life Threatening ◽  
Magnetic Resonance Imaging Mri ◽  
Ct And Mri

Abstract One week after Oxford-AstraZeneca COVID-19 vaccine (AZD1222), a 40-year-old woman who did not report previous SARS-Cov2 infection developed headache resistant to analgesics, then nausea and vomiting. On admission, the neurological examination was negative and haematological exams showed thrombocytopenia (48x10 9 /L; range 130-400), increased d-dimer (27,546 ng/ml; normal value <500), and normal partial thromboplastin time (PTT; 24.9; range 24-38). Brain computed tomography (CT) and magnetic resonance imaging (MRI) identified an extended thrombosis involving left sigmoidal and transversal sinuses, rectus and inferior longitudinal sinuses without parenchymal damages. Serum anti-platelet factor 4 (PF4) IgG antibodies tested strongly positive (2.59 optical density; normal <0.4) confirming the hypothesis of a mechanisms mimicking heparin-induced thrombocytopenia. Enoxaparin 8,000 units were administered twice in 24 hours, then changed with fondaparinux. Four days later the clinical picture worsened with drowsiness, aphasia and right-side hemiparesis. Brain CT and MRI disclosed left-side temporal-occipital hypodensity with haemorrhagic infarctions. Platelet count remained low (range 37 to 45x10 9 /L) while PTT decreased below the lower normal value. Intravenous immunoglobulin (2 g/kg) was started. Over the following 5 days, the platelet count rapidly increased from 27x10 9 /L to 318x10 9 /L, while PTT normalized. The clinical picture significantly improved.Anti-PF4 antibody assay and high-dose IVIG therapy should be immediately considered in patients with vaccine-induced prothrombotic immune thrombocytopenia (VIPIT) and thrombosis to avoid life-threatening complications.

scholarly journals High Dose Steroids as First-Line Treatment Increased the Risk of In-Hospital Infections in Patients With Anti-NMDAR Encephalitis

2021 ◽  
Vol 12 ◽  
Author(s):  
Jierui Wang ◽  
Jingfang Lin ◽  
Minjin Wang ◽  
Zirui Meng ◽  
Dong Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prediction Model ◽  
Ivig Therapy ◽  
Hospital Infection ◽  
Neurologic Outcome ◽  
Inflammatory Factors ◽  
High Dose ◽  
Complication Rates ◽  
Lasso Regression ◽  
Nmdar Encephalitis

ObjectiveTo address the effects of high dose steroids on in-hospital infection and neurologic outcome in anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis patients.MethodsWe retrospectively reviewed the clinical data of anti-NMDAR encephalitis patients in West China Hospital, the Third Hospital of Mianyang and Mianyang Central Hospital between October 2011 and August 2020. The development of infections, inflammatory factors, neurologic outcome at discharge and risk factors for in-hospital infection were assessed in patients with and without high dose steroid therapy before and after immunotherapy. Least absolute shrinkage and selection operator (LASSO) regression and logistic regression models were established to assess risk factors for in-hospital infection.ResultsA total of 278 patients with anti-NMDAR encephalitis were included in the study. Thirty-four patients received high dose methylprednisolone (IVMP) therapy only, 84 patients received intravenous immunoglobulin (IVIG) therapy, and 160 patients received IVIG and IVMP therapy. Compared with the IVIG group, IVIG + IVMP group had a higher infection rate (64.38% vs 39.29%, P &lt; 0.001), a higher incidence of noninfectious complications (76.25% vs 61.90%, P = 0.018) and a higher modified Rankin Scale (mRS) score at discharge from the hospital (3 vs 2, P &lt; 0.001). Inflammatory indicators, including white blood cell (WBC) count, neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII), were higher (9.93 vs 5.65, 6.94 vs 3.47 and 1.47 vs 0.70, respectively, P &lt; 0.001) in the IVIG + IVMP group than in the IVIG group. Moreover, lymphocyte-to-monocyte ratio (LMR) was lower (2.20 vs 2.54, P = 0.047) in the IVIG + IVMP group. The LASSO model showed that mRS score on admission, seizure, body temperature, uric acid (URIC), cerebrospinal fluid immunoglobulin G (CSF IgG), NLR and LMR were risk factors for in-hospital infection. The prediction model exhibited an area under the curve (AUC) of 0.885.ConclusionsHigh dose steroids therapy was significantly associated with higher in-hospital infectious complication rates and a poor short-term prognosis in relatively severe anti-NMDAR encephalitis patients. The established prediction model might be helpful to reduce the risk of in-hospital infection.

High-Dose Intravenous Immunoglobulin (IVIG) Therapy in Autoimmune Skin Blistering Diseases

2009 ◽  
Vol 38 (2-3) ◽  
pp. 186-195 ◽  
Author(s):  
Norito Ishii ◽  
Takashi Hashimoto ◽  
Detlef Zillikens ◽  
Ralf J. Ludwig
Keyword(s):  
Intravenous Immunoglobulin ◽  
Ivig Therapy ◽  
High Dose

Efficacy and Limitation of Infliximab Treatment for Children with Kawasaki Disease Intractable to Intravenous Immunoglobulin Therapy: Report of an Open-label Case Series

2012 ◽  
Vol 39 (4) ◽  
pp. 864-867 ◽  
Author(s):  
MASAAKI MORI ◽  
TOMOYUKI IMAGAWA ◽  
RYOKI HARA ◽  
MASAKO KIKUCHI ◽  
TAKUMA HARA ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Intravenous Immunoglobulin ◽  
Ivig Therapy ◽  
High Dose ◽  
Infliximab Treatment ◽  
Coronary Artery Lesions ◽  
Open Label ◽  
Intravenous Immunoglobulin Therapy ◽  
Cell Counts

Objective.Kawasaki disease (KD) is an acute febrile disease in infants and young children. Five percent to 8% of cases will be complicated with coronary dilatation or aneurysm, although introduction of high-dose intravenous immunoglobulin (IVIG) therapy has provided remarkable results for reducing the frequency of cardiac involvement. We describe the results of an open-label trial of infliximab, an anti-tumor necrosis factor-α monoclonal antibody, for suppressing the progression of coronary artery lesions in cases of KD refractory to extensive IVIG therapy. Plasma exchange (PE) was available as a rescue therapy for patients refractory to infliximab.Methods.Twenty eligible patients fulfilled the diagnostic criteria for KD, and were primarily treated with IVIG up to 4 g/kg. “Refractory to IVIG” was defined as persisting or reemerging fever > 38°C and positive fractional changes of C-reactive protein, white blood cell counts, or neutrophil counts 48 hours after IVIG infusion. These cases were treated with infliximab, 5 mg/kg, which should begin within 10 days of disease onset. PE for patients refractory to infliximab was performed with 5% albumin.Results.There was rapid improvement of inflammatory symptoms as well as normalization of the inflammatory markers. Sequential examination by echocardiography up to disease Day 30 revealed that the inflamed and mildly dilated coronary artery at the beginning of the study regressed to normal size in the convalescent phase. Two out of 20 patients showed incomplete improvement of inflammatory symptoms after infliximab treatment, and were provided with PE therapy, with no complications.Conclusion.Eighteen of 20 patients were effectively treated with infliximab, and 2 cases were effectively treated with PE to prevent progression to coronary artery lesions. No adverse event such as anaphylactoid reaction, heart failure, severe infectious diseases, or tuberculosis was observed in this trial.

scholarly journals Serum miR-200c and miR-371-5p as the Useful Diagnostic Biomarkers and Therapeutic Targets in Kawasaki Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-8
Author(s):  
Wei Zhang ◽  
Yan Wang ◽  
Yiwen Zeng ◽  
Liyi Hu ◽  
Guotao Zou
Keyword(s):  
Kawasaki Disease ◽  
Plasma Exchange ◽  
Intravenous Immunoglobulin ◽  
Therapeutic Targets ◽  
Ivig Therapy ◽  
High Dose ◽  
Healthy Controls ◽  
Diagnostic Biomarkers ◽  
Qrt Pcr ◽  
Serum Micrornas

Kawasaki disease (KD) has complexly clinical features and laboratory parameters and there is no definitive biomarker for this disease and the therapy of KD also is complex and uncertain. In this study, 102 KD patients and 80 healthy controls were enrolled in this study and the serum microRNAs were detected by qRT-PCR. The results showed that, compared with KD patients with a good response to high-dose intravenous immunoglobulin (IVIG) therapy, serum miR-200c and miR-371-5p were significantly higher in KD patients with no response to IVIG therapy; compared with KD patients not needing plasma exchange, these two microRNAs were also significantly higher in KD patients needing plasma exchange. In addition, combination of serum miR-200c and miR-371-5p reflected obvious separation between KD patients and healthy controls or between KD patients with no response to IVIG therapy and KD patients with good response to IVIG therapy or KD patients needing plasma exchange and KD patients not needing plasma exchange. Finally, both serum miR-200c and miR-371-5p were also significantly lower in KD under different kinds of therapy. Therefore, serum miR-200c and miR-371-5p have ability as the useful diagnostic biomarkers and therapeutic targets in Kawasaki disease.

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