Intravenous Immunoglobulin Therapy in Dermatologic Disorders

Abstract

Intravenous immunoglobulin (IVIG) is sterilized and purified human plasma which contains supra-physiologic levels of immunoglobulin G. IVIG is currently used in the treatment of immunodeficiency syndromes, inflammatory disorders and infectious diseases. Although numerous immunomodulatory mechanisms have been suggested, the exact mechanisms of action are poorly understood. There is also accumulating evidence that high-dose IVIG is efficacious in the treatment of some skin diseases, despite the lack of evidence from randomized, double-blind, placebo-controlled trials. Though in most cases, IVIG is only effective in combination with other immunomodulating strategies, it offers new hope for the treatment of many severe dermatologic conditions. This article focuses on the efficacy and safety of IVIG therapy in skin diseases.

Update on the use of immunoglobulin in human disease: A review of evidence

“…Sporadic case reports, as well as prospective and retrospective, multicenter studies have shown that early administration of high-dose IVIG helped to halt the progression of disease and reduce fatality. 522 Most reported patients were treated with IVIG in conjunction with other drugs, such as corticosteroids. A more recent and relatively large-scale (65 patients), retrospective study of IVIG (in addition to corticosteroids) in these disorders also showed a trend toward earlier resolution and reduced mortality, although results were not statistically significant.…”

“…Case reports suggesting improvement with IVIG exist in these additional disorders affecting the skin not covered elsewhere in this review: psoriasis, pyoderma gangrenosum, pretibial myxedema, and Mucha-Habermann disease. 522 More recent reports also include dystrophic calcinosis cutis 525 and scleromyxedema. 526 Other organ-specific diseases Cardiac disease.…”