Intravenous immunoglobulin treatment: Where do dermatologists stand?

Abstract

Intravenous immunoglobulins (IVIG) are therapeutic products, comprising polyclonal IgGs, which are obtained from human plasma pool of healthy blood donors. Despite the lack of Food and Drug Administration (FDA) approval, the experience of using IVIG in various dermatological diseases increases day by day and exciting results are reported. However, experience with the use of IVIG in dermatological indications are mostly case reports whereas randomized, controlled, double‐blind, multicentric studies have not been performed. Dermatological diseases treated with IVIG are autoimmune bullous skin diseases, Stevens‐Johnson syndrome and toxic epidermal necrolysis, connective tissue diseases, pyoderma gangrenosum, severe atopic dermatitis, chronic urticaria, Kawasaki disease, pretibial myxoedema, scleredema, and graft‐versus‐host disease.

Intravenous immunoglobulin therapy in children with severe atopic dermatitis

“…The different outcome in the latter study may be because a single cycle of IVIG therapy was not sufficient to modulate the course of severe AD. The effectiveness of IVIG for the treatment of AD has also been reported in numerous case studies 10–14 …”

“…The effectiveness of IVIG for the treatment of AD has also been reported in numerous case studies. [10][11][12][13][14] Several studies found that IVIG treatment led to a decrease in serum IgE levels. 7 This effect is probably due to the action of antiidiotypic antibodies found in IVIG products, which bind to IgE, thus clearing them from circulation.…”

Toxic epidermal necrolysis complicated with respiratory failure in children: A case report

“…A randomized controlled trial conducted by Wang et al in Taiwan [ 12 ] showcased improved clinical outcomes through the use of TNF-α antagonist (etanercept) therapy for SJS/TEN, that included complications such as mortality, skin healing duration, and gastrointestinal bleeding. The median healing time for TEN with TNF-α antagonist treatment ranged from 8 to 9 days, necessitating prompt initiation of treatment [ 13 ]. Among the cases discussed here, the patient who eventually succumbed to late complications did not receive TNF-α antagonist combination therapy.…”

Immunosuppressive and immunomodulator therapy for rare or uncommon skin disorders in pandemic days

“…Use of IVIG obtained from people who have undergone the disease is on the agenda in patients with critical COVID‐19 pneumonia 61‐63 . The patient must apply to a hospital or a health care facility, where he/she can have had his/her infusion for IVIG use.…”