Clinical uses of intravenous immune globulin: immunoglobulin replacement therapy and treatment of XXXX .

@entity1 @entity29 @entity134 @entity1398 @entity7491 @entity7893 @entity272 @entity13570 @entity792
Intravenous immune globulin (IVIG) is indicated for IgG replacement in antibody deficiency syndromes and as immunoregulatory therapy in some @entity792 . Two case histories illustrate both aspects of IVIG therapy. 1. @entity1 1 is a 24-year-old male with @entity7893 . He was successively treated with monthly IMIG, paternal plasma, and then over the last 5 years, IVIG. On IgG doses of 250 mg/kg q/4 weeks, IgG trough levels remained below 200 mg IgG/dl. IgG half-life was reduced. Although asymptomatic for prolonged periods of time, he eventually developed clinically evident @entity29 . Optimal IVIG replacement therapy requires normal IgG half-life and adequate IgG trough levels. 2. @entity1 2 is a 12-year-old @entity1 with @entity1398 , recurrent @entity272 , and @entity13570 unresponsive to antibiotics and to @entity134 therapy. IVIG at a dose of 3,000 mg/IgG/kg over 3 days significantly increased her neutrophil count. Subsequently, she has required 1,000 mg/kg of IVIG q/4 weeks for maintenance. Antineutrophil autoantibodies have persisted. There is synergism of IVIG with high doses of corticosteroids. The mechanism of action of IVIG seems to involve a blockage of the RES system. IVIG therapy is safe even at high doses for most @entity1 . However, anaphylactic reactions have been observed in @entity7491 @entity1 with IgE anti-IgA antibodies. The full spectrum of therapeutic applications of IVIG is still being explored. For some @entity1 self-infusion of IVIG at home is an appealing treatment alternative.
