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

Author(s):  
Nuh Kumru ◽  
Saliha Yarımoğlu ◽  
Tayfun Et ◽  
Rafet Yarımoğlu ◽  
Muhammet Korkusuz

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.

2014 ◽  
Vol 1 (1) ◽  
pp. 13
Author(s):  
Kazu Ode ◽  
Yoshinori Taniguchi ◽  
Yoshitaka Kumon ◽  
Yoshio Terada

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.


2021 ◽  
Vol 12 ◽  
Author(s):  
Hidefumi Kato ◽  
Megumi Hayashi ◽  
Wataru Ohashi ◽  
Takamasa Yamaguchi ◽  
Satomi Tanaka ◽  
...  

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.


2021 ◽  
Author(s):  
Carla Zanferrari ◽  
Simona Fanucchi ◽  
Nicola L. Liberato ◽  
Giuseppe Lauria ◽  
Alessandra Persico ◽  
...  

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.


2020 ◽  
Vol 15 (5) ◽  
Author(s):  
Rozita Khodashahi ◽  
Alireza Sedaghat ◽  
Mandana Khodashahi

Introduction: The outbreak of coronavirus disease 2019 (COVID-19) should be considered a serious threat to global public health. Due to a large number of infected and dead people, the development of approaches to control the epidemic condition, as well as effective and available drugs, is very important. Case Presentation: In this study, we presented three cases with COVID-19 admitted to the Imam Reza Hospital. A high dose of intravenous immunoglobulin (IVIG) was used for patients as potent and safe treatment. Moreover, case reports and case series focusing on the patients with COVID-19 were reviewed in the present study. During the literature search, 27 patients with COVID-19 were identified in 14 studies. Fever, sore throat, dry cough, fatigue, chills, and muscle pain were the common primary complications of the patients. Kaletra, oseltamivir, ceftriaxone, hydroxychloroquine, azithromycin, and IVIG were the most prevalent drugs for the treatment of COVID-19. Conclusions: Except for the current study, IVIG was utilized in two other studies to treat patients with COVID-19, who did not respond to other therapies.


2009 ◽  
Vol 38 (2-3) ◽  
pp. 186-195 ◽  
Author(s):  
Norito Ishii ◽  
Takashi Hashimoto ◽  
Detlef Zillikens ◽  
Ralf J. Ludwig

2012 ◽  
Vol 39 (4) ◽  
pp. 864-867 ◽  
Author(s):  
MASAAKI MORI ◽  
TOMOYUKI IMAGAWA ◽  
RYOKI HARA ◽  
MASAKO KIKUCHI ◽  
TAKUMA HARA ◽  
...  

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.


2017 ◽  
Vol 2017 ◽  
pp. 1-8
Author(s):  
Wei Zhang ◽  
Yan Wang ◽  
Yiwen Zeng ◽  
Liyi Hu ◽  
Guotao Zou

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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