INTRAVENOUS IMMUNE GLOBULIN


Made by precipitating Ig from donor plasma with alcohols

May in rare cases cause oliguric renal failure (MMWR 48:518, 1999--JW)

*only well-established uses of IVIG is for ITP and Kawasaki's*

May be helpful in treatment of Toxic Shock Syndrome

Clinical applications:

  1. Polymyositis/dermatomyositis (Lancet, 1990, uncontro-led, 13/15 pts improved)
  2. Myasthenia gravis (7 uncontrolled studies c 54 total pts, 80-100% response rates, starts 3wks post-tx, lasts 2-3mos)
  3. Guillain-Barre (NEJM 1/92, 150pts, IVIG vs plasmapheresis; more & faster improv. c IVIG up to 6mos post tx)
  4. CIDPN (uncontrolled, 9 pts, all pts showed improvement)
  5. Multifocal conduction block motor neuropathy (1 uncontrolled study with + response)
  6. Epilepsy (Lancet 84, 8 children with post-encephalitic sz dis. + improv. if <2y post onset)
  7. Pemphigus Vulgaris