INTRAVENOUS IMMUNOGLOBULIN INFUSION THERAPY IN WOMEN WITH RECURRENT SPONTANEOUS-ABORTIONS OF IMMUNE ETIOLOGIES

We have investigated clinical effectiveness of intravenous immunoglobu lin G infusion (IVIg) on antiphospholipid antibody titers in five wome n with evidence of antiphospholipid antibody-associated recurrent spon taneous abortions and one with antinuclear antibody who became refract ory to conventional autoimmune treatment during pregnancy and experien ced pregnancy complications. Three women developed intrauterine growth retardation and three had complicated twin pregnancies with rising au toantibody titers. Antiphospholipid antibody and antinuclear antibody titers were tested pre and 2 weeks after each IVIg infusion. We report that: (i) IgG antiphospholipid antibody titers were significantly sup pressed after each IVIg infusion (P < 0.05); (ii) IgM antiphospholipid antibody titers were also significantly suppressed after each IVIg in fusion (P < 0.0001); (iii) decreased titers of autoantibodies parallel ed increased levels of maternal IgG which lasted for at least 30 days; the autoantibodies showed a definite rise again prior to the next inf usion; (iv) antinuclear antibody titers were effectively suppressed; a nd (v) rising autoantibody titers combined clinical manifestation of i ntrauterine growth retardation and women with complicated twin pregnan cies. We conclude that IVIg infusion effectively suppresses IgM and Ig G autoantibodies to phospholipids and antinuclear antibody in autoimmu ne women with a history of recurrent spontaneous abortions and refract ory to conventional anticoagulation or immunosuppressive treatment.