Efficacy of intravenous immunoglobulin in autoimmune neurological diseases. Literature systematic review and meta-analysis

Morales-Ruiz, Valeria; Juárez-Vaquera, Víctor Hugo; Rosetti-Sciutto, Marcos F.; Sánchez‐Muñoz, Fausto; Adalid‐Peralta, Laura

doi:10.1016/j.autrev.2021.103019

Cited by 20 publications

(25 citation statements)

References 81 publications

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“…A meta-analysis by Morales-Ruiz et al showed beneficial effect of IVIG administration on patients with various autoimmune neurological conditions over placebo (OR=2.79, P=0.01). 35 In addition, a recent randomized blinded study showed IVIG efficacy over placebo in controlling seizures in a small number of patients with leucine-rich glioma-inactivated 1 (LGI1) and contactin-associated protein-like 2 (CASPR2) autoimmune epilepsy. 36 Its efficacy compared to other first-line agents, and its clinical benefit as an add-on therapy, remains to be clearly established in AE.…”

Section: First-line Therapiesmentioning

confidence: 99%

Anti-NMDA Receptor Autoimmune Encephalitis: Diagnosis and Management Strategies

Nguyen¹,

Wang²

2023

IJGM

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Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is the most recognized form of autoimmune encephalitis. It is characterized by a constellation of neurologic and psychiatric features along with positive NMDAR antibody, which is more sensitive and specific in CSF than serum. All patients should be screened at least once for neoplasm, with ovarian teratoma being found in most tumor-related cases. In the acute phase, first-line immunotherapy, often a combination of high-dose steroids, immunoglobulins, and/or plasma exchange, is strongly recommended. When first-line therapy fails, escalation to second-line immunotherapy, particularly rituximab, can further improve outcomes and prevent relapses. In refractory cases, additional complementary immunotherapies, such as cyclophosphamide, bortezomib and/or tocilizumab may be considered. Relapses occur in 10–30% of cases, mostly within the first two years from onset. Individuals should be followed up to determine if chronic maintenance therapy is required.

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Section: First-line Therapiesmentioning

confidence: 99%

Anti-NMDA Receptor Autoimmune Encephalitis: Diagnosis and Management Strategies

Nguyen¹,

Wang²

2023

IJGM

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“…No clinical details are available from those cases. The pathophysiology of GBS in SLE patients remains speculative and is thought to involve lupus-induced auto-antibodies against myelin tissue ( 3 , 29 ).…”

Section: Discussionmentioning

confidence: 99%

“…The classical description refers to the landmark paper by Guillain et al ( 1 ). “GBS” syndrome ( 2 ) is thought to be a post-infectious autoimmune disease, resulting from the immune-mediated injury of myelin and/or axonic neurons; the contribution of genetically mediated dysregulation of inflammation and immune responses has been postulated [summarized in ( 3 , 4 )]. GBS has been described occasionally in systemic lupus erythematosus (SLE) patients ( 5 – 8 ), generally without preceding infection.…”

Section: Introductionmentioning

confidence: 99%

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Case Report: Guillain-Barré Syndrome as Primary Presentation of Systemic Lupus Erythematosus (SLE-GBS) in a Teenage Girl

et al. 2022

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Peripheral nervous system involvement accounts for fewer than 10% of SLE cases with neuropsychiatric manifestations. Guillain-Barré syndrome (GBS) as the presenting, major manifestation of pediatric SLE is extremely rare, and the best treatment approach is unknown. A 14-year-old, previously healthy female teenager developed classic features of GBS with ascending bilateral muscle weakness leading to respiratory insufficiency, associated with protein-cell dissociation in cerebro-spinal fluid, nerve root enhancement by MRI and reduction in compound muscle action potential amplitude. SLE was diagnosed serologically and histologically (lupus nephritis WHO class II). Despite immediate treatment with intravenous immunoglobulin (IVIg), methylprednisolone pulses and subsequently, rituximab, the patient required prolonged mechanical ventilation. She achieved full recovery following 14 PLEX treatments and two more rituximab infusions. Anti-dsDNA, C3, C4 and urinalysis normalized while anti-Smith and Sjögren antibodies persisted 15 months after disease onset, with no other lupus manifestations. Review of the literature revealed two pediatric cases of GBS at the onset of SLE and a third case with GBS 6 years after the diagnosis of SLE. Conventional GBS therapy may not be adequate to treat SLE-GBS. SLE should be included in the differential diagnosis of GBS. Importantly, treatment experiences and outcomes of such cases need be reported to inform future treatment recommendations.

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“…At the beginning, an update on IVIG therapy in COVID-19 was delivered by Goddard-Zandman. It is well documented that IVIG is a useful, safe, off-label medication that can be used for long-term treatment for a number of autoimmune illnesses by which IVIG has been shown to reduce immune responses [ 191 , 192 ]. IVIG comes in a variety of formats such as specific IVIG (sIVIG), and subcutaneous IVIG (scIVIG).…”

Section: Infection and Autoimmunity During Auto13mentioning

confidence: 99%