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https://www.readbyqxmd.com/read/27913549/second-line-therapies-in-immune-thrombocytopenia
#1
Rachael F Grace, Cindy Neunert
Immune thrombocytopenia (ITP) is a rare, acquired autoimmune condition characterized by a low platelet count and an increased risk of bleeding. Although many children and adults with ITP will not need therapy beyond historic first-line treatments of observation, steroids, intravenous immunoglobulin (IVIG), and anti-D globulin, others will have an indication for second-line treatment. Selecting a second-line therapy depends on the reason for treatment, which can vary from bleeding to implications for health-related quality of life (HRQoL) to likelihood of remission and patient preference with regard to adverse effects, route of administration, and cost...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913085/anti-n-methyl-d-aspartate-receptor-encephalitis-and-rasmussen-like-syndrome-an-association
#2
Kevin Gurcharran, Shefali Karkare
BACKGROUND: N-methyl-D-aspartate (NMDA) receptor encephalitis is an immune-mediated condition that has a broad spectrum of manifestations, including seizures, coma, psychosis, and focal neurological deficits. Although usually a diffuse process, unihemispheric involvement mimicking early stages of Rasmussen encephalitis can occur. Rasmussen's encephalitis is a unique syndrome characterized by progressive hemiplegia, drug-resistant focal epilepsy, cognitive decline, and hemispheric brain atrophy contralateral to the hemiplegia...
October 11, 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/27911458/spondylodiscitis-a-rare-complication-following-percutaneous-nephrostomy
#3
Francesco Chiancone, Maurizio Fedelini, Clemente Meccariello, Luigi Pucci, Marco Fabiano, Paolo Fedelini
Spondylodiscitis is an inflammation of the intervertebral disc and the adjacent vertebral bodies. The spondylodiscitis can not only be a complication of medical interventions such as an operation near spinal column but also urogenital and vascular interventions and intravenous catheter use. A 71-year-old man was admitted to our emergency department with fever and severe abdominal pain. Antibiotic therapy had been performed with intravenous administration of 2 g of ceftriaxone and the patient underwent the placement of a percutaneous nephrostomy according to Seldinger technique...
November 28, 2016: Urologia
https://www.readbyqxmd.com/read/27908534/critical-review-of-the-role-of-intravenous-immunoglobulins-in-idiopathic-inflammatory-myopathies
#4
REVIEW
Sabrina Anh-Tu Hoa, Marie Hudson
OBJECTIVE: The aim of this review was to summarize key findings from the literature concerning the therapeutic role of intravenous immunoglobulins (IVIg) in idiopathic inflammatory myopathies (IIM), dissecting the evidence according to disease subtype and treatment indication, and to review the evidence relating to the mechanism of action of IVIg in IIM to ascertain rationale for continued research. METHODS: Medline (Ovid) and Pubmed databases were searched from inception to July 2016 using relevant keywords...
July 29, 2016: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/27907966/getting-rid-of-weakness-in-the-icu-an-updated-approach-to-the-acute-management-of-myasthenia-gravis-and-guillain-barr%C3%A3-syndrome
#5
Alexis A Lizarraga, Karlo J Lizarraga, Michael Benatar
After prompt diagnosis, severe myasthenia gravis and Guillain-Barré syndrome (GBS) usually require management in the intensive care unit. In the myasthenic patient, recognition of precipitating factors is paramount, and frequent monitoring of bulbar, upper airway, and/or respiratory muscle strength is needed to identify impending myasthenic crisis. Noninvasive ventilation can be attempted prior to intubation and mechanical ventilation in the setting of respiratory failure. Cholinesterase inhibitors should be discontinued, but resumed prior to extubation, and steroid dosage could be increased once the airway is secured...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27904583/the-role-of-intravenous-immunoglobulin-in-treatment-of-mucous-membrane-pemphigoid-a-review-of-literature
#6
REVIEW
Soheil Tavakolpour
BACKGROUND: Mucous membrane pemphigoid (MMP) is considered an autoimmune blistering disease that predominantly affects mucous membranes. Various treatments are available for controlling the diseases, but not all of them may respond. MATERIALS AND METHODS: PubMed and Google Scholar were searched for all the associated studies until 2015, using the keywords such as "cicatricial pemphigoid" or "ocular pemphigoid" or "mucous membrane pemphigoid" or "MMP" and "intravenous immunoglobulin" or "IVIg" to find all the relevant studies...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27903373/-therapeutic-effect-of-severe-thrombocytopenia-in-patients-underwent-transcatheter-patent-ductus-arteriosus-occlusion
#7
P Zhang, X Y Zhu, D Z Zhang, Q G Wang, X M Han, X T Sheng, C S Cui
Objective: To investigate the therapeutic effect of severe thrombocytopenia in patients underwent transcatheter patent ductus arteriosus occlusion. Methods: Clinical data of 80 pure patent ductus arteriosus patients who underwent interventional occlusion between February 2011 and November 2014 in General Hospital of Shenyang Military Region were retrospective analyzed.A bolus of heparin calcium (80 U/kg) was administered by intravenous injection during the procedure.Blood test was conducted in all patients before and after the procedure...
October 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/27902746/the-effect-of-intravenous-immunoglobulin-combined-with-corticosteroid-on-the-progression-of-stevens-johnson-syndrome-and-toxic-epidermal-necrolysis-a-meta-analysis
#8
Liang-Ping Ye, Cheng Zhang, Qi-Xing Zhu
BACKGROUND: Intravenous immunoglobulin (IVIG) treatment is commonly used to treat Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) with controversial therapeutic effect. METHODS: We conducted a comprehensive meta-analysis through combining the published eligible studies to evaluate the effectiveness of IVIG on SJS and TEN treatment. RESULTS: A total of 26 studies were selected from public available databases. The combination of IVIG and corticosteroid markedly reduced the recovery time (by 1...
2016: PloS One
https://www.readbyqxmd.com/read/27901259/neurological-manifestations-of-chikungunya-and-zika-infections
#9
Talys J Pinheiro, Luis F Guimarães, Marcus Tulius T Silva, Cristiane N Soares
The epidemics of Chikungunya virus (CHIKV) and Zika virus (ZIKV) infections have been considered the most important epidemiological occurrences in the Americas. The clinical picture of CHIKV infection is characterized by high fever, exanthema, myalgia, headaches, and arthralgia. Besides the typical clinical picture of CHIKV, atypical manifestations of neurological complications have been reported: meningo-encephalitis, meningoencephalo-myeloradiculitis, myeloradiculitis, myelitis, myeloneuropathy, Guillain-Barré syndrome and others...
November 2016: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/27900974/disseminated-mycobacteria-chelonae-infection-in-a-kidney-pancreas-transplant-recipient-a-case-report-and-review-of-the-literature
#10
Shafi Malik, Ananda Ghosh, Shahid Husain
A 40-year-old male with a long-standing history of type 1 diabetes with end-stage renal failure underwent combined kidney-pancreas (KP) transplant from a standard criteria donor. Post-operative course was uncomplicated with good primary function of both transplant grafts. Induction was with thymoglobulin and maintenance immunosuppression was with tacrolimus, mycophenolate mofetil and prednisolone. Nine weeks post-transplant, the patient developed dysfunction of both grafts. Panel reactive antibody testing revealed that the patient had developed a de novo donor-specific antibody and considering an antibody-mediated rejection the patient was treated with intravenous pulse methyl prednisone 500 mg ×3 doses, IV immunoglobulin 2 mg/kg in two divided doses, and ATG 7 mg/kg (total dose of 700 mg)...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27900773/systematic-review-of-immunoglobulin-use-in-paediatric-neurological-and-neurodevelopmental-disorders
#11
REVIEW
Jonathan Gadian, Emma Kirk, Kate Holliday, Ming Lim, Michael Absoud
AIM: A systematic literature review of intravenous immunoglobulin (IVIG) treatment of paediatric neurological conditions was performed to summarize the evidence, provide recommendations, and suggest future research. METHOD: A MEDLINE search for articles reporting on IVIG treatment of paediatric neuroinflammatory, neurodevelopmental, and neurodegenerative conditions published before September 2015, excluding single case reports and those not in English. Owing to heterogeneous outcome measures, meta-analysis was not possible...
November 30, 2016: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/27897446/life-threatening-rituximab-induced-pyoderma-gangrenosum-successfully-treated-with-intravenous-immunoglobulin
#12
J Vikse, A Rygh, K Kaisen, R Omdal
No abstract text is available yet for this article.
November 29, 2016: Scandinavian Journal of Rheumatology
https://www.readbyqxmd.com/read/27893416/the-effect-of-fc%C3%AE-riia-and-fc%C3%AE-riib-on-coronary-artery-lesion-formation-and-intravenous-immunoglobulin-treatment-responses-in-children-with-kawasaki-disease
#13
Ling-Sai Chang, Mao-Hung Lo, Sung-Chou Li, Ming-Yu Yang, Kai-Sheng Hsieh, Ho-Chang Kuo
Previous research has found patients with the FcγRIIIB NA1 variant having increased risk of intravenous immunoglobulin (IVIG) resistance in Kawasaki disease (KD). Our previous studies revealed that elevated FcγRIIA expression correlated with the susceptibility of KD patients. We conducted this research to determine whether and how Fcγ receptors affect the susceptibility, IVIG treatment response, and coronary artery lesions (CAL) of KD patients. The activating FcγRIIA and inhibitory FcγRIIB methylation levels of seven patients with KD and four control subjects were examined using HumanMethylation27 BeadChip...
November 21, 2016: Oncotarget
https://www.readbyqxmd.com/read/27891499/a-presumptive-case-of-human-rabies-a-rare-survived-case-in-rural-ghana
#14
Paschal Awingura Apanga, John Koku Awoonor-Williams, Michael Acheampong, Matthew Ayamba Adam
Rabies remains endemic in Ghana and continues to pose a major public health threat to humans and animals with a nearly 100% case fatality rate in humans. We report of a presumptive case of human rabies whose survival represents a rare occurrence in rural Ghana and worldwide. Lessons from this case study provide a critically needed focus in helping improve rabies surveillance and case management in Ghana. We report of the survival of a 36-year-old man who developed clinical rabies after he was bitten by his dog, while restraining the dog with a chain...
2016: Frontiers in Public Health
https://www.readbyqxmd.com/read/27889733/steroid-pulse-therapy-for-kawasaki-disease-complicated-with-myocarditis
#15
Tomomi Sato, Junpei Somura, Yoshihiro Maruo
BACKGROUND: The clinical management of intravenous immunoglobulin-resistant Kawasaki disease shock syndrome (KDSS) is obscure. CASE CHARACTERISTICS: Three children presented with intravenous immunoglobulin-resistant KDSS complicated with myocarditis. OUTCOME: All cases were successfully managed with steroid pulse therapy. MESSAGE: Steroid pulse therapy is effective in immunoglobulin-resistant KDSS.
November 15, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27886913/biologics-in-chronic-urticaria
#16
REVIEW
Adeeb Bulkhi, Andrew J Cooke, Thomas B Casale
Chronic urticaria (CU) is defined as wheals, angioedema, or both, that last more than 6 weeks. Second-generation antihistamines are considered the first-line therapy for CU. Unfortunately, many patients will fail antihistamines and require alternative therapy, including immune response modifiers or biologics. Multiple biological agents have been evaluated for use in antihistamine-refractory CU, including omalizumab, rituximab, and intravenous immunoglobulin; omalizumab is the most efficacious. Because of the success of omalizumab, multiple new biologics that are directed at the IgE pathway are under investigation...
February 2017: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/27886797/catastrophic-antiphospholipid-syndrome-the-current-management-approach
#17
REVIEW
Ignasi Rodriguez-Pintó, Gerard Espinosa, Ricard Cervera
The current recommendation for catastrophic antiphospholipid syndrome (CAPS) management is the standard triple therapy with anticoagulation (AC), glucocorticoids (GCs), plasma exchange (PE), and/or intravenous immunoglobulins (IVIGs). Of note, only AC has a significant effect on the prognosis of these patients. However, from the experimental or basic point of view, there is only indirect evidence to advocate the use of these immunomodulatory therapies (GC, PE, and IVIG) in CAPS. Recently, there have been reports of severe or refractory CAPS patients treated with the monoclonal antibodies rituximab and eculizumab...
April 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27885866/thymic-derived-tolerizing-dendritic-cells-are-upregulated-in-the-spleen-upon-treatment-with-intravenous-immunoglobulin-in-a-murine-model-of-immune-thrombocytopenia
#18
Rick Kapur, Rukhsana Aslam, Michael Kim, Li Guo, Heyu Ni, George B Segel, John W Semple
Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder characterized by low platelet counts. First-line treatment includes intravenous immunoglobulin (IVIg), however, its working mechanism remains incompletely understood. We investigated splenic and thymic dendritic cell (DC) subsets upon IVIg treatment in a well-characterized active murine model of ITP. During active disease, there was a significant peripheral deficiency of splenic tolerizing SIRPα+ DCs which could be rescued by IVIg therapy, increasing platelet counts...
November 25, 2016: Platelets
https://www.readbyqxmd.com/read/27884572/tick-borne-encephalitis-virus-neutralization-by-high-dose-intravenous-immunoglobulin
#19
Jana Elsterova, Martin Palus, Jana Sirmarova, Jan Kopecky, Hans Helmut Niller, Daniel Ruzek
Tick-borne encephalitis (TBE) is a potentially lethal neuroinfection in humans, caused by TBE virus (TBEV). Currently, there are no approved therapeutic agents to treat TBE. Previously, it was suggested that application of high dose intravenous immunoglobulin (IVIG) may pose potentially successful treatment for severe cases of TBE. In this study, we determined the titers of TBEV-neutralizing antibodies in two IVIG lots originating from the same manufacturer, and tested their ability to treat a lethal TBEV-infection in a mouse model...
November 18, 2016: Ticks and Tick-borne Diseases
https://www.readbyqxmd.com/read/27884454/-management-of-adverse-effects-related-to-human-immunoglobulin-therapy-recommendations-for-clinical-practice
#20
I Marie, P Chérin, M Michallet, E Pelus, J Dantal, J-C Crave, J-C Delain, J-F Viallard
Both intravenous and subcutaneous immunoglobulins are therapeutic modalities approved in various conditions, including primary and secondary immune deficiencies and autoimmune disorders. To date, immunoglobulins have more often been considered as a safe medication, with minor adverse effects such as hypertension, fever and chills, nausea, myalgia or headache. However, with the wider use of immunoglobulins in the treatment of autoimmune diseases, severe side effects have also been reported to occur in immunoglobulin-treated patients, especially anaphylaxis, aseptic meningitis, acute renal impairment, thrombotic events as well as haematological manifestations...
November 21, 2016: La Revue de Médecine Interne
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