 |
 |

Dermatological Uses of High-Dose Intravenous Immunoglobulin
Stephen Jolles, MSc, MRCP;
Jenny Hughes, MRCP;
Sean Whittaker, MD, MRCP
Arch Dermatol. 1998;134:80-86.
High-dose intravenous immunoglobulin (hdIVIg) is increasingly used to treat a range of inflammatory and autoimmune diseases. The current dermatological uses of hdIVIg include the treatment of dermatomyositis and the autoimmune bullous disorders, epidermolysis bullosa acquisita, pemphigoid, and pemphigus. Numerous immunomodulatory mechanisms for hdIVIg have been proposed, and they are discussed alongside treatment protocols and adverse effects. Increasing use of this therapy has helped to establish its excellent safety record, without the many adverse effects of steroids and other immunosuppressive agents. This safety record makes hdIVIg an attractive therapeutic option; however, in view of the time required to administer the infusions, the cost, and the urgent need for controlled trials of hdIVIg in patients with specific dermatological disorders such as pemphigus, patients must be carefully selected. Unfortunately, current dermatological uses of hdIVIg have been limited to either uncontrolled trials or anecdotal case reports, except for a single controlled trial of hdIVIg as adjunctive therapy in patients with dermatomyositis, which documented a significant benefit. Further trials in dermatomyositis should be established to confirm these data and to clarify the dose and frequency of therapy required for patients with dermatomyositis. When using hdIVIg, liaison between the dermatologist and the immunologist is helpful because it allows the use of both the nursing and the medical expertise of an existing immunotherapy unit. If appropriate, the patient may be entered into an hdIVIg home therapy training program, such as the one that exists for primary immunodeficiency and some neurologic indications, with clear benefits in quality of life and inpatient costs.
CiteULike Connotea Del.icio.us Digg Reddit Technorati Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
 |
Severe eczematous skin reaction after high-dose intravenous immunoglobulin infusion: report of 4 cases and review of the literature.
Vecchietti et al.
Arch Dermatol 2006;142:213-217.
ABSTRACT
| FULL TEXT
Paraneoplastic Pemphigus Associated With Castleman Tumor: A Commonly Reported Subtype of Paraneoplastic Pemphigus in China
Wang et al.
Arch Dermatol 2005;141:1285-1293.
ABSTRACT
| FULL TEXT
Consensus Statement on the Use of Intravenous Immunoglobulin Therapy in the Treatment of Autoimmune Mucocutaneous Blistering Diseases
Ahmed and Dahl
Arch Dermatol 2003;139:1051-1059.
ABSTRACT
| FULL TEXT
Analysis of Intravenous Immunoglobulin for the Treatment of Toxic Epidermal Necrolysis Using SCORTEN: The University of Miami Experience
Trent et al.
Arch Dermatol 2003;139:39-43.
ABSTRACT
| FULL TEXT
Comparison Between Intravenous Immunoglobulin and Conventional Immunosuppressive Therapy Regimens in Patients With Severe Oral Pemphigoid: Effects on Disease Progression in Patients Nonresponsive to Dapsone Therapy
Ahmed and Colon
Arch Dermatol 2001;137:1181-1189.
ABSTRACT
| FULL TEXT
High-Dose Intravenous Immunoglobulin in Cutaneous Lupus Erythematosus
Genereau et al.
Arch Dermatol 1999;135:1124-1125.
FULL TEXT
Inhibition of Toxic Epidermal Necrolysis by Blockade of CD95 with Human Intravenous Immunoglobulin
Viard et al.
Science 1998;282:490-493.
ABSTRACT
| FULL TEXT
|