Intravenous Immunoglobulins

This biological agent based on polyclonal antibodies derived from human pool plasma has been used for a long time in diverse clinical conditions for antibody substitution as well as therapeutic intervention (Jolles et al. 1998, Rutter and Luger 2001, Sacher 2001). In the latter cases, divergent mechanisms on the humoral and cellular levels seem to be operative, including anticytokine effects, complement inactivation, and modulation of regulatory functions of different inflammatory cells. Autoimmune diseases are beyond the licensed applications yet are treated with partly beneficial results. No clinical studies are available on LE, but reports on a limited number of patients document beneficial effects in refractory CLE at high doses of 1-2 g/kg body weight every 4 weeks (De Vita et al. 1996, Genereau et al. 1999, Piette 1995). Minimal side effects are opposed to high costs. Therefore, intravenous immunoglobulins should only be used as an adjuvant in recalcitrant disease or initial treatment in combination with other immunosuppressive agents.

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