INTRAVENOUS IMMUNOGLOBULINS IN THE THERAPY OF AUTOIMMUNE AND SYSTEMICINFLAMMATORY DISORDERS

Objective: The focus of this review is to summarize the mechanism and the adverse side-effects of Intravenous Immunoglobulin (IVIg) therapy, and to highlight the current cumulative experience of its use in the treatment and management of autoimmune and systemic inflammatory disea ses. Data sources: Detailed search of the literature was done. Studies involving only humans were considered for clinical evaluation. Animal studies were used only for understanding mechanisms of action. The NI H Consensus Conference of May 1990 and the Australian Society for Bloo d Transfusion of July 1993 were used for guidelines. Study Selection: Material was taken only from peer reviewed journals. Results: It appea rs that IVIg may act by more than one mechanism of action. It is uncle ar whether the mechanism is different in different diseases and whethe r more than one mechanism may apply to any disease or clinical state. The incidence and gravity of serious side effects appears low. It is t he mainstay of treatment of immune thrombocytopenia purpura and Kawasa ki disease. Conclusion: IVIg is a safe and effective therapeutic modal ity that can be added to the repertoire of various agents used to trea t autoimmune and systemic inflammatory diseases. Long-term prospective studies are needed to define indications, dose-schedules, duration of therapy, and influence on the clinical courses of chronic diseases be tter.