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- W2009487696 abstract "Background: Recent literature reports intravenous immunoglobulin (IVIg) as an effective treatment for a variety of skin diseases, most notably immunobullous disease refractory to conventional immunosuppressive therapy. Our anecdotal experience with IVIg has been less favorable than published studies. Objective: To examine the use and effectiveness of IVIg treatment for skin disease at Mayo Clinic. Methods: Patients who had received IVIg for skin disease between 1996 and 2003 at Mayo Clinic were identified. The following information was sought: disease duration and severity, previous immunosuppressive regimens, IVIg administration protocol, concomitant therapy, and response to IVIg treatment. In addition to comparing patients’ symptoms and signs before and after therapy, pertinent lab tests and fluctuations in concomitant immunosuppressive doses needed to control disease were used as surrogate indices of treatment efficacy. Results: 19 patients with skin disease were treated with IVIg: immunobullous disease [11 patients (pemphigus vulgaris (7) bullous pemphigoid (3) and cicatrical pemphigoid (1))]; dermatomyositis (2); mixed connective tissue disease (1); chronic urticaria (1); scleromyxedema (1); leukocytoclastic vasculitis (1); linear IgA bullous disease (1); and toxic epidermal necrolysis (1). Responses of each disease were as follows: pemphigus vulgaris (1 PR, 6 NR); bullous pemphigoid (1 CR, 3 NR); dermatomyositis (1 CR, 1 PR); mixed connective tissue disease (1 CR); chronic urticaria (1 CR); scleromyxedema (1 CR); leukocytoclastic vasculitis (1 PR); linear IgA bullous disease (1 CR); and toxic epidermal necrolysis (1 NR). Overall, 10 of the 19 patients (53%) experienced no clinical response to IVIg therapy. 6 patients (31%) experienced a complete clinical response, while 3 patients (16%) exhibited a partial response. 9 of the 11 patients (82%) with autoimmune bullous disease experienced no clinical response. Non-responders received an average of 7 treatment cycles (ranging from 5 to 11) at a dose of 2g/kg per monthly cycle. Side effects from IVIg were mild and included headache, nausea, and myalgias. Discussion: Although the present study is a retrospective study of a small and heterogenous group, IVIg was effective in less than half of the patients with skin disease, and in particular, was not effective in the majority of the patients with autoimmune bullous disease. Conclusion: Our experience of IVIg for skin disease is less favorable than that reported in the literature. Further studies are needed to verify the efficacy of IVIg for skin disease." @default.
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- W2009487696 date "2004-03-01" @default.
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- W2009487696 title "Intravenous immunoglobulin therapy: effective in skin disease? a retrospective review of mayo clinic experience" @default.
- W2009487696 doi "https://doi.org/10.1016/j.jaad.2003.10.040" @default.
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