Neurológia pre prax 6/2011

Intravenous immunoglobulin therapy for autoimmune neurological disorders

Intravenous immunoglobulins (IVIg) have been used for treating various neuroimmunological diseases. Over the past years their efficacy could be demonstrated in placebo-controlled, double-blinded clinical trials. Use of IVIg has become the first-line treatment for Guillain-Barré syndrome, multifocal motor neuropathy, chronic inflammatory demyelinating polyneuropathy, and rapidly worsening myasthenia gravis. Furthermore, IVIg plays an important role as a second-line treatment in selected chronic treatment-refractory cases of polymyositis, dermatomyositis, Lambert-Eaton myasthenic syndrome, stiff-person syndrome, and also in postpartum-related relapses of multiple sclerosis. IVIg is well tolerated, easily administered, and is often efficacious with a relatively rapid action. Due to an excellent safety profile, IVIg has been used very liberally for most diseases with suspected autoimmune pathology or where there is no treatment available. Therefore, IVIg should be principally used according to available data from controlled clinical trials. Here we review the clinical applications and recommendations for the use of IVIg in autoimmune neurologic diseases.

Keywords: intravenous immunoglobulin, Guillain-Barré syndrome, multifocal motor neuropathy, chronic inflammatory demyelinating polyneuropathy, myasthenia gravis, Lambert-Eaton myasthenic syndrome, polymyositis, dermatomyositis, stiff-person syndrome, sclerosis multiplex.