Clinical applications of intravenous immunoglobulins in neurology

Intravenous immunoglobulin (IVIg) is used increasingly in the management of patients with neurological conditions. The efficacy and safety of IVIg treatment in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and Guillain-Barré syndrome (GBS) have been established clearly in randomiz...

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Bibliographic Details
Published in:Clinical and experimental immunology 2009-12, Vol.158 (Supplement_1), p.34-42
Main Authors: Hughes, R.A.C, Dalakas, M.C, Cornblath, D.R, Latov, N, Weksler, M.E, Relkin, N
Format: Article
Language:English
Subjects:
Adult and adolescent clinical studies
Alzheimer disease
Alzheimer Disease - drug therapy
Alzheimer's disease
Analytical, structural and metabolic biochemistry
Autoimmune Diseases of the Nervous System - drug therapy
autoimmune myopathy
Biological and medical sciences
chronic inflammatory demyelinating polyradiculoneuropathy
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Fundamental and applied biological sciences. Psychology
Guillain-Barre Syndrome - drug therapy
Guillain-Barré syndrome
Humans
Immunoglobulins, Intravenous - therapeutic use
intravenous immunoglobulin
Medical sciences
Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis
Myositis - drug therapy
Neurology
Organic mental disorders. Neuropsychology
Polyradiculoneuropathy, Chronic Inflammatory Demyelinating - drug therapy
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Review
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Summary:Intravenous immunoglobulin (IVIg) is used increasingly in the management of patients with neurological conditions. The efficacy and safety of IVIg treatment in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and Guillain-Barré syndrome (GBS) have been established clearly in randomized controlled trials and summarized in Cochrane systematic reviews. However, questions remain regarding the dose, timing and duration of IVIg treatment in both disorders. Reports about successful IVIg treatment in other neurological conditions exist, but its use remains investigational. IVIg has been shown to be efficacious as second-line therapy in patients with dermatomyositis and suggested to be of benefit in some patients with polymyositis. In patients with inclusion body myositis, IVIg was not shown to be effective. IVIg is also a treatment option in exacerbations of myasthenia gravis. Studies with IVIg in patients with Alzheimer's disease have reported increased plasma anti-Aβ antibody titres associated with decreased Aβ peptide levels in the cerebrospinal fluid following IVIg treatment. These changes at the molecular level were accompanied by improved cognitive function, and large-scale randomized trials are under way.
ISSN:0009-9104
1365-2249
DOI:10.1111/j.1365-2249.2009.04025.x