Intravenous immunoglobulin (i.v. IgG) for previously treated acute or for chronic XXXX ( @entity3039 ) in childhood: a prospective multicenter study.

@entity1 @entity3039 @entity882 @entity548
In a prospective multicenter study 42 @entity882 (less than 30 X 10(9) platelets/l) @entity1 with chronic @entity3039 ( @entity3039 ) or with @entity3039 , dependent on or refractory to corticosteroids, were given 0.4 g i.v. IgG/kg body weight/day on 5 consecutive days and thereafter once a week if the platelet count fell to less than 20 X 10(9)/l or if the @entity1 bled. After the initial 5 days of i.v. IgG the platelets rose within a mean of 7-8 days to greater than 30 X 10(9)/l in all and to greater than 150 X 10(9)/l in 33 of 42 @entity1 (79%). After a mean observation time of 26.6 months 26 of 42 @entity1 (62%) showed a satisfactory long-term effect, i.e. no need for treatment for at least 6 months without @entity548 and with no platelet counts below 20 X 10(9)/l. No difference in response rate was found between @entity1 with chronic and those with previously treated @entity3039 . These results indicate that i.v. IgG could be used to control emergency situations, e.g. to stop @entity548 or to prepare a @entity1 for surgery. I.v. IgG also represents a good alternative to treatment modalities, such as splenectomy and/or the administration of cytostatic immunosuppressants with potentially serious side effects. In addition to the expected transient rise in serum IgG levels, i.v. IgG induced a more prolonged elevation of serum IgM. Platelet associated IgG, elevated before therapy, was correlated with the clinical long-term outcome.
