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https://www.readbyqxmd.com/read/28588812/chronic-sinusitis-in-a-patient-with-selective-igg4-subclass-deficiency-controlled-with-enriched-immunoglobulins
#1
Gérard Dine, Nadia Ali-Ammar, Said Brahimi, Yves Rehn
A 71-year-old female patient with no major history of infection had presented with recurrent chronic purulent sinusitis over the past 3 years. These recurrent infections started in 2000 with otolaryngologists' support before diagnosis of IgG4 deficiency be asked. The patient was treated with increasingly extensive courses of antibiotics and underwent several maxillary and sphenoidal sinus washouts. She continued to present with purulent nasal discharge containing Staphylococcus epidermidis. The blood and immune work-ups were normal...
June 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28581272/the-usefulness-of-platelet-derived-microparticle-as-biomarker-of-antiplatelet-therapy-in-kawasaki-disease
#2
Hyun Jung Kim, Eun Hye Choi, Yeon Jung Lim, Hong Ryang Kil
Little is known about platelet dynamics and the effect of antiplatelet therapy in Kawasaki disease (KD). This study sought to define platelet activation dynamics in KD patients by assaying platelet-derived microparticles (PDMPs). We measured plasma PDMPs levels in 46 patients with KD using an enzyme-linked immunosorbent assay (ELISA). Blood samples were collected before, at 2-5 days, and 9-15 days after intravenous immunoglobulin (IVIG) infusion, 2 months and 4-5 months after the onset of KD. We measured PDMP levels in 23 febrile and 10 afebrile control patients...
July 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28551598/novel-variant-of-common-variable-immunodeficiency
#3
Eileen Conaway
A 57-year-old woman with frequent respiratory infections was initially diagnosed with IgG subclass deficiency based on low levels of IgG subclasses 2 and 3. Three years later, she progressed to having IgA deficiency as well. With a normal total IgG level, she does not meet criteria for common variable immunodeficiency (CVID). This may represent a variant of CVID. This also highlights the importance of immunoglobulin subclass estimation in patients where immunodeficiency is suspected clinically. She is being treated with rotational antibiotics the first 10 days of every month, monthly intravenous immunoglobulin (IVIG) infusion and osteopathic manipulation one to two times per month...
May 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28543448/successful-treatment-of-pure-red-cell-aplasia-because-of-abo-major-mismatched-stem-cell-transplant
#4
Katie Sackett, Claudia S Cohn, Kayla Fahey-Ahrndt, Angela R Smith, Andrew D Johnson
BACKGROUND: Pure red cell aplasia (PRCA) is a well-documented potential side effect of ABO major mismatched allogeneic hematopoietic stem cell transplants. This side effect may be self-limiting, but is sometimes treated using modalities such as steroids, antithymocyte globulin, donor lymphocyte infusions, rituximab, or plasma exchanges. Another well-documented cause of pure red cell aplasia is a chronic parvovirus B19 infection, which may be seen in immunocompromised hosts. The treatment of this cause of PRCA includes removal of immunosuppression, intravenous immunoglobulin (IVIg), or rituximab; however, this condition may also be self-limiting...
May 24, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28520084/renal-and-hematologic-side-effects-of-long-term-ivig-therapy-in-patients-with-neurologic-disorders
#5
Aidan A Levine, Todd D Levine, Kathie Clarke, David Saperstein
INTRODUCTION: For patients receiving intravenous immunoglobulin (IVIG), renal and hemolytic side effects are well recognized. However, there is very little data on the effects of chronic IVIG therapy. METHODS: We retrospectively analyzed laboratory data on 166 patients who received IVIG for 12 months with dosing from 0.441 gm/kg/month to 2.58 gm/kg/month, measuring changes in hematocrit and glomerular filtration rates (GFR) at 6 and 12 months. RESULTS: Of the 2,232 infusions, there were no incidents of clinical hemolysis...
May 18, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28508388/positive-clinical-outcome-in-a-patient-with-recalcitrant-bullous-pemphigoid-treated-with-rituximab-and-intravenous-immunoglobulin
#6
T Nguyen, A R Ahmed
A 41-year-old white man was treated for bullous pemphigoid (BP) for 4 years, using high-dose prednisone as well as ciclosporin and mycophenolate mofetil. Sustained clinical improvement was not observed. He suffered several serious side effects. Consequently, he was treated with a combination of rituximab (RTX) and intravenous immunoglobulin (IVIg). He received 12 infusions of RTX in 6 months and monthly IVIg until the end of the therapy. Within 5 weeks of this therapy, appearance of new lesions ceased. Within 8 weeks, all previous lesions resolved and previous medications were discontinued...
May 15, 2017: Clinical and Experimental Dermatology
https://www.readbyqxmd.com/read/28469537/rituximab-for-treatment-of-refractory-anti-nmda-receptor-encephalitis-in-a-pediatric-patient
#7
Sarah Hallowell, Esli Tebedge, Margaret Oates, Elizabeth Hand
Anti-N-methyl d-aspartate receptor (anti-NMDAR) encephalitis is a devastating disease that is increasingly being identified in both children and adults with psychosis, language disturbances, behavioral changes, and motor deficits. Currently no consensus guidelines exist for the optimal management of patients with this disease, although intravenous immune globulin (IVIG) therapy is often considered first-line pharmacotherapy. We present a case of an otherwise healthy 4 year-old-child who presented with seizures, loss of age-appropriate language skills, and behavioral changes, in whom anti-NMDAR was subsequently diagnosed...
March 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28452863/efficacy-and-factors-associated-with-treatment-response-of-intravenous-immunoglobulin-in-inpatients-with-refractory-inflammatory-bowel-diseases
#8
Nicholas Horton, Gursimran Kochhar, Kajal Patel, Rocio Lopez, Bo Shen
BACKGROUND: The administration of intravenous immunoglobulin (IVIG) has demonstrated promise in the treatment of medically refractory inflammatory bowel diseases (IBD). We aimed to identify factors associated with IVIG failures in the treatment of refractory IBD. METHODS: Our historical cohort included patients with refractory IBD admitted to our inpatient service with an exacerbation and treated with at least 1 dose of IVIG (0.4 g/kg). Detailed clinical variables were recorded for subjects...
July 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28422989/the-lack-of-btk-does-not-impair-monocytes-and-polymorphonuclear-cells-functions-in-x-linked-agammaglobulinemia-under-treatment-with-intravenous-immunoglobulin-replacement
#9
Filomena Monica Cavaliere, Alessandro Prezzo, Caterina Bilotta, Metello Iacobini, Isabella Quinti
The lack of BTK in X-linked agammaglobulinemia (XLA) patients does not affect monocytes and polymorphonuclear cells (PMN) phenotype and functions. In this study, we show that XLA patients had an increased frequency of the intermediate monocytes subset and that BTK-deficient monocytes and PMN had a normal expression of receptors involved in the activation and cellular responses. We demonstrate that BTK is not required for migration, phagocytosis and the production of reactive oxygen species (ROS) following engagement of FC gamma receptors (FcγR)...
2017: PloS One
https://www.readbyqxmd.com/read/28421246/immunoglobulin-g-for-patients-with-necrotising-soft-tissue-infection-instinct-a-randomised-blinded-placebo-controlled-trial
#10
Martin B Madsen, Peter B Hjortrup, Marco B Hansen, Theis Lange, Anna Norrby-Teglund, Ole Hyldegaard, Anders Perner
PURPOSE: The aim of the INSTINCT trial was to assess the effect of intravenous polyspecific immunoglobulin G (IVIG) compared with placebo on self-reported physical function in intensive care unit (ICU) patients with necrotising soft tissue infection (NSTI). METHODS: We randomised 100 patients with NSTI 1:1 to masked infusion of 25 g of IVIG (Privigen, CSL Behring) or an equal volume of 0.9% saline once daily for the first 3 days of ICU admission. The primary outcome was the physical component summary (PCS) score of the 36-item short form health survey (SF-36) 6 months after randomisation; patients who had died were given the lowest possible score (zero)...
April 18, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28394917/a%C3%AE-levels-in-the-jugular-vein-and-high-molecular-weight-a%C3%AE-oligomer-levels-in-csf-can-be-used-as-biomarkers-to-indicate-the-anti-amyloid-effect-of-ivig-for-alzheimer-s-disease
#11
Takashi Kasai, Masaki Kondo, Ryotaro Ishii, Akihiro Tanaka, Suzuka Ataka, Hiroyuki Shimada, Takami Tomiyama, Hiroshi Mori, Mark Taylor, David Allsop, Masanori Nakagawa, Toshiki Mizuno, Takahiko Tokuda
Intravenous immunoglobulin (IVIg) has been a candidate as a potential anti-amyloid immunotherapy for Alzheimer disease (AD) because it contains anti-amyloid β (Aβ) antibodies. Although several studies with IVIg in AD have been published, changing levels of Aβ efflux from the brain, or disaggregation of Aβ species induced by immunotherapy, have not been properly investigated. Here, we carried out an open label study of therapy with IVIg in five patients with AD. We collected plasma from a peripheral vein (peripheral-plasma) and from the internal jugular vein (jugular-plasma) to estimate directly the efflux of soluble Aβ from the brain...
2017: PloS One
https://www.readbyqxmd.com/read/28381506/a-phase-3-trial-of-iv-immunoglobulin-for-alzheimer-disease
#12
RANDOMIZED CONTROLLED TRIAL
Norman R Relkin, Ronald G Thomas, Robert A Rissman, James B Brewer, Michael S Rafii, Christopher H van Dyck, Clifford R Jack, Mary Sano, David S Knopman, Rema Raman, Paul Szabo, David M Gelmont, Sandor Fritsch, Paul S Aisen
OBJECTIVE: We tested biweekly infusions of IV immunoglobulin (IVIg) as a possible treatment for mild to moderate Alzheimer disease (AD) dementia. METHODS: In a phase 3, double-blind, placebo-controlled trial, we randomly assigned 390 participants with mild to moderate AD to receive placebo (low-dose albumin) or IVIg (Gammagard Liquid; Baxalta, Bannockburn, IL) administered IV at doses of 0.2 or 0.4 g/kg every 2 weeks for 18 months. The primary cognitive outcome was change from baseline to 18 months on the 11-item cognitive subscale of the Alzheimer's Disease Assessment Scale; the primary functional outcome was 18-month change on the Alzheimer's Disease Cooperative Study-Activities of Daily Living Inventory...
May 2, 2017: Neurology
https://www.readbyqxmd.com/read/28378901/pharmacokinetics-and-pharmacodynamics-of-intravenous-immunoglobulin-g-maintenance-therapy-in-chronic-immune-mediated-neuropathies
#13
Wjr Fokkink, Bcp Koch, Crb Ramakers, P A van Doorn, T van Gelder, B C Jacobs
The regimen for intravenous immunoglobulin (IVIg) maintenance treatment varies considerably between patients with chronic immune-mediated neuropathies. Although it is widely recognized that treatment regimens should be improved, detailed pharmacokinetics of IVIg have not been established. We aimed to determine the pharmacokinetics of IVIg maintenance treatment in patients with clinically stable, treatment-dependent chronic immune-mediated neuropathy. Patients received a median IVIg dose of 30 (15 - 70) grams every 14 (7 - 28) days resulting in high IgG peak levels (median 25...
April 5, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28370513/high-dose-intravenous-immunoglobulin-therapy-for-scleromyxoedema-a-prospective-open-label-clinical-trial-using-an-objective-score-of-clinical-evaluation-system
#14
A Guarneri, M Cioni, F Rongioletti
BACKGROUND: Scleromyxoedema is a primary fibro-mucinosis whose therapy is still challenging. OBJECTIVE: To evaluate the safety and efficacy of high-dose intravenous immunoglobulin (IVIg) for the management of scleromyxoedema prospectively using an objective score. METHODS: In a prospective open-label study, IVIg was administered to eight patients with scleromyxoedema in a dose of 2 g/kg per month. The patients were followed-up to a minimum of 6 months, and their disease activity and response to treatment were assessed using the Physician's Global Assessment of disease severity (PGA) and a modified objective skin scoring system for patients with scleroderma (modified Rodnan score system for scleromyxoedema or mRSSS)...
March 29, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28362052/plasmapheresis-intravenous-immunoglobulins-and-autologous-serum-eyedrops-in-the-acute-eye-complications-of-toxic-epidermal-necrolysis
#15
Antonio Pinna, Eleonora Nuvoli, Francesco Blasetti, Maria Alma Posadinu, Francesco Boscia
PURPOSE: Toxic epidermal necrolysis (TEN) is a rare, life-threatening, drug-induced, mucocutaneous disease, which can severely affect the ocular surface. The purpose of this study was to investigate the efficacy of plasmapheresis, human IV immunoglobulins (IVIg), and autologous serum (AS) eyedrops in the treatment of the severe acute ocular complications of TEN. METHODS: A retrospective chart review of all patients admitted to the Burn Unit, Azienda Ospedaliero-Universitaria-Sassari, Sassari, Italy, from 2009 to 2015, identified 9 patients (2 men, 7 women; mean age 63...
March 21, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28345437/clinical-profile-dosing-and-quality-of-life-outcomes-in-primary-immune-deficiency-patients-treated-at-home-with-immunoglobulin-g-data-from-the-ideal-patient-registry
#16
Sean Kearns, Loretta Kristofek, William Bolgar, Luqman Seidu, Samantha Kile
BACKGROUND: Patients with primary immune deficiency (PID) often require immunoglobulin G (IgG, commonly referred to as Ig) replacement therapy to prevent infections and associated comorbidities. Ig therapy can be given either through intravenous or subcutaneous routes, and both can be done in the home setting. There is limited information available on the real-world diagnosis, management, and outcomes of this patient population, given the variable disease presentation and treatment options...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28316003/evaluation-of-the-safety-tolerability-and-pharmacokinetics-of-gammaplex-%C3%A2-10-versus-gammaplex-%C3%A2-5-in-subjects-with-primary-immunodeficiency
#17
RANDOMIZED CONTROLLED TRIAL
Richard L Wasserman, Isaac R Melamed, Mark R Stein, Stephen Jolles, Miranda Norton, James N Moy
PURPOSE: This phase 3, multicenter, open-label, randomized, two-period, crossover bioequivalence trial evaluated the safety, tolerability, and pharmacokinetics of intravenous immunoglobulins (IVIGs) Gammaplex 5% and Gammaplex 10% in 33 adults and 15 children with primary immunodeficiency diseases (PIDs). METHODS: Eligible adults received five Gammaplex 5% infusions followed by five Gammaplex 10% infusions, or vice versa, stratified by a 21- or 28-day dosing regimen...
April 2017: Journal of Clinical Immunology
https://www.readbyqxmd.com/read/28240400/low-dose-prednisone-and-immunoglobulin-g-treatment-for-woman-at-risk-for-neonatal-alloimmune-thrombocytopenia-and-t-helper-1-immunity
#18
Annie Skariah, Nayoung Sung, Maria D Salazar Garcia, Li Wu, Anjali Tikoo, Alice Gilman-Sachs, Joanne Kwak-Kim
PROBLEM: Fetal and neonatal alloimmune thrombocytopenia is an alloimmune disorder resulting from platelet opsonization by maternal antibodies that destroy fetal platelets. As there is no antenatal screening or immunization to prevent sensitization, selection of high-risk population or the prevention of antenatal sensitization is significantly limited. METHOD OF STUDY: (i) A case report of ante- and postnatal management of a woman with paternal homozygosity for human platelet antigen-1(HPA) incompatibility...
June 2017: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/28224702/early-platelet-and-leukocyte-decline-in-patients-with-neuroinflammatory-disorders-after-intravenous-immunoglobulins
#19
A Totzeck, M Stettner, T Hagenacker
BACKGROUND AND PURPOSE: Intravenous immunoglobulins (IVIGs) are a common therapy in patients with neuroinflammatory disorders, especially chronic inflammatory demyelinating polyradiculoneuropathy or Guillain-Barré syndrome. Hematological toxicities upon IVIG infusion are a known side effect and still an important subject of investigation. METHODS: Laboratory results and data for clinical efficacy and tolerability of 62 patients with neuroinflammatory disorders treated with IVIG (0...
April 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28213939/protective-antibodies-against-clostridium-difficile-are-present-in-intravenous-immunoglobulin-and-are-retained-in-humans-following-its-administration
#20
O H Negm, B MacKenzie, M R Hamed, O A J Ahmad, C C Shone, D P Humphreys, K Ravi Acharya, C E Loscher, I Marszalowska, M Lynch, M H Wilcox, T M Monaghan
The prevalence of serum antibodies against Clostridium difficile (CD) toxins A and B in healthy populations have prompted interest in evaluating the therapeutic activity of intravenous immunoglobulin (IVIg) in individuals experiencing severe or recurrent C. difficile infection (CDI). Despite some promising case reports, a definitive clinical role for IVIg in CDI remains unclear. Contradictory results may be attributed to a lack of consensus regarding optimal dose, timing of administration and patient selection as well as variability in specific antibody content between commercial preparations...
June 2017: Clinical and Experimental Immunology
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