Use of IGIV in the treatment of atopic dermatitis, urticaria, scleromyxedema, pyoderma gangrenosum, psoriasis, and pretibial myxedema

Jolles, Stephen; Hughes, Jenny

doi:10.1016/j.intimp.2005.11.017

Cited by 58 publications

(59 citation statements)

References 49 publications

(59 reference statements)

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“…Felton et al successfully treated a patient using a combination of surgical and octreotide treatment, resulting in local control of skin lesions lasting more than nine years (19). Jolles et al reported the clinical improvement of pretibial myxedema in patients treated using high dose intravenous immunoglobulin therapy (20).…”

Section: Discussionmentioning

confidence: 99%

Radiation therapy as part of the therapeutic regimen for extensive multilocular myxedema in a patient with exophthalmos, myxedema and osteoarthropathy syndrome: A case report

et al. 2015

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Abstract. Exophthalmos, myxedema and osteoarthropathy (EMO) comprise the triad known as EMO syndrome, which is rarely observed in patients with autoimmune thyroid disease. The present study reports the case of a patient with EMO, including the response of this rare combination to radiotherapy. A 48-year-old patient with EMO syndrome presented to the Department of Radiation Oncology, University Hospital of Muenster, eight years prior to writing with therapy-resistant pretibial myxedema and hypertrophic osteoarthropathy of the metacarpal bones. The patient had been diagnosed with Graves' disease (GD) 26 years prior to presentation, which was treated by thyroidectomy and radioiodine therapy. Four years subsequent to the diagnosis of GD, the patient developed exophthalmos, which was treated using radiotherapy. An evident pretibial, foot and hand myxedema developed within the 10 years following the onset of orbitopathy. The skin lesions were treated using radiation therapy subsequent to the failure of multiple surgical procedures and medical treatments. Almost eight years subsequent to the administration of irradiation, no recurrence was observed on the lower right leg, nor was any recurrence on the lower left leg observed approximately four years subsequent to the completion of radiotherapy. However, an additional lesion on the left hand demonstrated slow progression following treatment with radiation therapy. The present study indicates that radiation therapy can be considered as adjuvant therapy for patients with refractory myxedema, to prevent or delay the recurrence of myxedema subsequent to surgical excision.

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Section: Discussionmentioning

confidence: 99%

Radiation therapy as part of the therapeutic regimen for extensive multilocular myxedema in a patient with exophthalmos, myxedema and osteoarthropathy syndrome: A case report

et al. 2015

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“…Bazı yazarlar bu temelden yola çıkarak IVIG tedavisinin psoriaziste uygulanabileceğini öne sürmüşlerdir. IVIG'in, TNF-α gibi sitokinlerin oluşumunu inhibe ederek psoriaziste uygulanabileceği öne sürülmüştür [6][7][8][9][10][11][12][13][14][15] . Gebelikte de çeşitli otoimmun hastalıklarda güvenle kullanılabilmesi ve iyi tolere edilmesi sebebiyle de teratojenik olmadığı bilinmektedir 7 .…”

Section: Discussionunclassified

“…Birçok otoimmun ve inflamatuvar hastalıkta kullanılan immunsupresif bir ajan olarak tanımlanmıştır. Gebelerde, otoimmun trombositopenik purpura ve tekrarlayan düşük tedavisinde yaygın olarak kullanılması sebebiyle, iyi tolere edilebilen ve güvenilir bir tedavi seçeneği olarak görülmektedir 6,7 . Bu olgu sunumuyla, tedaviye dirençli İH tanılı hastada IVIG'in tedavideki etkinliğine dikkat çekilerek, İH'de bir tedavi seçeneği olarak gözönünde bulundurulabileceği düşünülmektedir.…”

Section: Gi Riflunclassified

Tedaviye Dirençli İmpetigo Herpetiformis'te İntravenöz İmmunglobulin Tedavisinin Etkinliği: Olgu Sunumu

...

2012

Turkderm

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Özetİmpetigo herpetiformis (İH), yüksek fetal morbidite ve mortaliteye sahip, bazen gebeliğin sonlandırılmasını gerektirebilen bir hastalıktır. Etkili olduğu belirtilen farklı tedavi seçenekleri bulunmaktadır. Yirmi üç yaşında, psoriazis öyküsü olan 25 haftalık gebe olgu, ani başlangıçlı jeneralize püstüler döküntülerle başvurdu. Klinik bulgular ve histopatolojik değerlendirme ile İH tanısı konuldu. Sistemik prednizolon (2 mg/kg/gün) üç hafta süreyle uygulandı. Yanıt olmadığı için siklosporin A (3mg/kg/gün) ilave edildi. İki hafta siklosporin A ve sistemik prednizolon kombine kullanılmasına rağmen deri bulguları gerilemedi. Tedavilere ek olarak 30. Sum maryImpetigo herpetiformis (IH), if left untreated, is associated with a high rate of perinatal morbidity and mortality and may lead to the decision of termination of pregnancy. There are various and effective therapeutic agents available for the treatment of the disease. A 23-year-old woman with a history of plaque psoriasis presented with a sudden generalized pustular eruption on the 25th week of her first gestation. The diagnosis was made based on the clinical and histopathological findings. The patient was treated with systemic prednisolone (2 mg/kg/d) first and, cyclosporine A (3 mg/kg/d) was added to the treatment after two weeks because prednisolone was not effective alone. The lesions did not regress despite four weeks of combined treatment with prednisolone and cyclosporine. Intravenous immunoglobuline (IVIG) (0.3 g/kg/d, 6 days) was added on the 30th week of gestation and resulted in regression of cutaneous rashes. On the 33rd week of gestation, IVIG (0.7 g/kg/d, 3 days) was repeated due to reactivation of pustules, and an improvement was observed. In this case report, we called attention to IVIG therapy in IH, for having the pregnancy continued enough for the fetal maturation before the delivery. (Turk derm 2012; 46: 104-6

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“…The notion that injection of immunoglobulins transiently decreases thyroid function is of clinical value given the growing number of conditions that are treated with i.v. immunoglobulins (26).…”

Section: Discussionmentioning

confidence: 99%

Toll-like receptor-MyD88 and Fc receptor pathways of mast cells mediate the thyroid dysfunctions observed during nonthyroidal illness

Rocchi¹,

Kimura²,

Tzou³

et al. 2007

Proc. Natl. Acad. Sci. U.S.A.

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Bacterial infections and other pathologic conditions induce complex dysfunctions of the hypothalamic-pituitary-thyroid axis, collectively known as nonthyroidal illness (NTI).innate immunity ͉ euthyroid sick syndrome ͉ mastocyte ͉ hypothyroidism N onthyroidal illness (NTI) is a common clinical condition defined as the biochemical changes of the hypothalamicpituitary-thyroid axis that occur in patients suffering from illnesses not primarily originating in the thyroid (1, 2). These illnesses include bacterial infections, burns, myocardial infarction, respiratory distress syndrome, cirrhosis, end-stage renal disease, psychosis, and starvation. The key serum biochemical changes in NTI, although varying with the type and severity of the initiating illness, consist of: (i) increased reverse tri-iodothyronine (T3), principally due to decreased activity of type I deiodinase (3), an enzyme in peripheral tissues (mainly liver) that converts reverse T3 to di-iodo-thyronine and, in decreasing order of affinity, thyroxine (T4) to T3 and T3 to di-iodothyronine; (ii) decreased T3, also secondary to decreased type I deiodinase activity (4); (iii) decreased T4 more likely due to a reduced binding capacity and/or affinity of serum carrier proteins for T4, given that the T4 production rate appears similar to that of healthy euthyroid individuals with low or absent T4-binding globulin (5, 6); and (iv) inappropriately normal or low levels of thyroid stimulating hormone (TSH) with respect to the decreased thyroid hormone levels. This defective TSH production is likely of hypothalamic origin in light of demonstrated reduction in TSH-releasing hormone (TRH) secretion from paraventricular nucleus neurons (7-9) and blunting of the physiological nocturnal TSH surge (10). It is unclear whether the thyroid gland is directly affected during NTI. An autopsy study showed that thyroids from deceased patients with chronic illness had lower weight, smaller follicles, and less colloid than thyroids from suddenly deceased, previously healthy controls (11).NTI has an incompletely understood pathogenesis (9). Some scholars consider it a salutary, physiologic adaptation to illness (to conserve energy by suppressing the catabolic effects of thyroid hormones), whereas others consider it a true pathologic state. Consequently, a frequent clinical debate is whether to administer synthetic T4 (12) or not (13) to patients with NTI, although the majority opinion opposes T4 administration. To gain mechanistic insights into the pathogenesis of bacterial NTI, numerous experiments have been performed in humans, mice, and rats by using injections of LPS. In humans, LPS induces flu-like symptoms (fever, chills, general malaise, muscle ache, headache, exacerbated sensitivity to light, and nausea), monocytopenia (14), and release of proinflammatory cytokines, including IL-1, IL-6, and TNF-␣ (15). Serum T4, T3, and TSH decrease, reaching a nadir after 6 h, and then return to baseline by 15 h (16). In mice and rats, LPS induces similar systemic illness (decreased food i...

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Use of IGIV in the treatment of atopic dermatitis, urticaria, scleromyxedema, pyoderma gangrenosum, psoriasis, and pretibial myxedema

Cited by 58 publications

References 49 publications

Radiation therapy as part of the therapeutic regimen for extensive multilocular myxedema in a patient with exophthalmos, myxedema and osteoarthropathy syndrome: A case report

Radiation therapy as part of the therapeutic regimen for extensive multilocular myxedema in a patient with exophthalmos, myxedema and osteoarthropathy syndrome: A case report

Tedaviye Dirençli İmpetigo Herpetiformis'te İntravenöz İmmunglobulin Tedavisinin Etkinliği: Olgu Sunumu

Toll-like receptor-MyD88 and Fc receptor pathways of mast cells mediate the thyroid dysfunctions observed during nonthyroidal illness

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