Idiopathic lumbosacral plexopathy is an uncommon idiopathic disorder characterized by acute onset of severe lower extremity pain, followed by weakness, atrophy of affected muscle, and variable sensory disturbance. A 61-year-old man experienced sudden onset of dysesthesia with weakness in right lower extremity. Electrodiagnostic study revealed patch pattern denervation at L3 and L4 root without paraspinal muscle involvement. Lumbar MRI showed abnormal signals in the right lumbar plexus. Pulse intravenous administration of high-dose immunoglobulin alleviated the sensorimotor symptoms. Abnormal signals in lumbar MRI reduced 6 months later.
Administration, Intravenous ; Atrophy ; Denervation ; Humans ; Immunoglobulins ; Lower Extremity ; Lumbosacral Plexus ; Middle Aged ; Muscles ; Paresthesia

Newborn premature babies have lwo levels of transplacentally acquired maternal immunoglobulin which is mostly transferred after 32~34 weeks gestaton, therefore they may have IgG deficiencies that increase their susceptibility to bacterial infection. We performed this study to determine whether intravenous immunoglobulin (IVIG) therapy improves mortality or infection occurrance rate. From 1 october 1991 to 31 July 1992, 73premature newborn infants with gestational age< or =34weeks were enrolled: the theatment group, consisting of 43infants who received prophylactic intravenous immunoglobulin therapy (500mg/kg/week) and the control group, consisting of 30infants who did not receive. prophylactic intravenous administration of immunoglobulin to preterm infants with a gestational ageage< or =34week, at a dose of 500mg/kg/week, results in maintenance of a satisfactory serum IgG level throughout the high-risk period for infection. But the incidence rates of proven or very probable sepsis, mortality for sepsis and total mortality in the infants receiving intravenous immunoglobulin were not significant differences when compared with those in the control infants. No adverse effects were noted after immunoglobulin transfusions in our subjects. In conclusion, our study does not show any decrease in bacterial infection rate or in mortality rate, and no study in the literature has shown absolute proof of the prophylactic efficacy of IVIG in premature newborns. Larger studies are necessary to confirm these observations and to determine more effective dosing schedules and the optimal levels of orhanism-spectific antibodies. And specific hyperimmnue of monoclonal antibody preparations may be required to provide reliable sources of effective prophylactic to premature neonate with high risk in bacterial sepsis.
Administration, Intravenous ; Antibodies ; Appointments and Schedules ; Bacterial Infections ; Humans ; IgG Deficiency ; Immunization, Passive ; Immunoglobulin G ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature* ; Mortality ; Sepsis*

Adolescent ; Female ; Humans ; Immunoglobulins, Intravenous ; administration & dosage ; Immunosuppressive Agents ; administration & dosage ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating ; diagnosis ; therapy

Heparin-induced thrombocytopenia (HIT) is a relatively infrequent complication of heparin administration. HIT can cause devastating thrombosis, making it one of the most serious adverse drug reactions encountered in clinical practice. We successfully treated a case of severe HIT presenting with thrombosis and life-threatening bleeding complications with intravenous immunoglobulin (IVIG), platelet transfusion and oral anticoagulant Rivaroxaban. In this case, we considered that IVIG played the most important role by preventing further thrombosis, increasing the platelet count, and ensuring the efficacy of Rivaroxaban. We therefore suggest that IVIG might be the optimal treatment for patients with this urgent condition.
Aged, 80 and over ; Female ; Heparin ; administration & dosage ; adverse effects ; Humans ; Immunoglobulins, Intravenous ; administration & dosage ; Platelet Transfusion ; Rivaroxaban ; administration & dosage ; Thrombocytopenia ; chemically induced ; therapy

Child ; Congresses as Topic ; Coronary Disease ; diagnosis ; etiology ; therapy ; Humans ; Immunoglobulins, Intravenous ; administration & dosage ; therapeutic use ; Incidence ; Injections, Intravenous ; International Cooperation ; Mucocutaneous Lymph Node Syndrome ; epidemiology ; etiology ; therapy

OBJECTIVETo evaluate the effect of intravenous immunoglobulin (IVIG) and vitamin C on the progression of experimental autoimmune myocarditis(EAM).

METHODSFifty-two Balb/c mice were randomized into six groups: The blank group received no treatment, the remaining 5 groups were immunized with 100mug emulsified porcine myosin at d 1 and d 7. Different agents were injected from d 1, SVitC group:150 mg/kg*d(-1)vitamin C; LVitC group: 300 mg/kg*d(-1)vitamin C; IVIG group: 1 g/kg*d(-1)IVIG; IVIG+VitC group: 1 g/kg*d(-1)IVIG and 150 mg/kg*d(-1)vitamin C; The control group same volume of normal saline. All mice were sacrificed at d 21, and serum TNF-alpha levels were detected with enzyme linked immunosorbent assay (ELISA). The ratio of heart to body weight(C/W), spleen to body weight(S/W) and kidney to body weigh(R/W) were calculated. The spleens and heart were examined pathologically and/or immunohistochemically.

RESULTCompared with those of control group, inflammatory cells infiltration in the myocardium and calcification in the pericardiume in SVitC and LVitC groups were extenuated. There were inflammatory cells infiltrating in the myocardium sparely and no calcification in the pericardium in IVIG and IVIG+VitC groups. The size of spleens enlarged especially in IVIG and IVIG+VitC groups. White and red pulps of spleens were hyperplastic microscopically. The C/W of treatment groups decreased significantly compared with that of control group. The S/W of therapy groups and control group was significantly higher than that of blank group; and the S/W of IVIG and IVIG + VitC groups was significantly higher than that of SVitC and LVitC groups. The R/W in each groups had no significant difference. The TNF-alpha level in SVitC and LVitC groups was a little lower than that in control group; TNF-alpha level in IVIG and IVIG+VitC groups was significantly lower than that of control group. Wide fluorescence stripe was found along extracellular matrix surrounding the damaged cardiomyocytes of control group. Both density and intensity of fluorescence in SVitC and LVitC groups were lower than those of control group. There were much wider fluorescence stripe and strengthened intensity in IVIG and IVIG + VitC groups. The myofilaments were in wild disorder and sarcomere had severe breakage in control group. Moreover, chondriosome hypertrophy and vacuolar degeneration were found. The damage lessened in SVitC and LVitC groups. Both myofilaments and sarcomeres in IVIG and IVIG + VitC groups were almost normal, and the chondriosome was normal.

CONCLUSIONIVIG and vitamin C have some protective and therapeutic effect on the progression of EAM by decreasing pathological damage of myocardium and depressing TNF-alpha production, and IVIG combined with vitamin C is more effective.

Animals ; Ascorbic Acid ; administration & dosage ; Autoimmune Diseases ; drug therapy ; Drug Therapy, Combination ; Female ; Immunoglobulins, Intravenous ; administration & dosage ; Injections, Intravenous ; Male ; Mice ; Mice, Inbred BALB C ; Myocarditis ; drug therapy ; Random Allocation ; Tumor Necrosis Factor-alpha ; blood ; gamma-Globulins ; administration & dosage

OBJECTIVETo systematically investigate the efficacy and safety of glucocorticoids (GCs) combined with intravenous injection of immunoglobulin (IVIG) in the initial treatment of Kawasaki disease (KD).

METHODSEDLINE Database, PubMed Database, CNKI, Wanfang Data, and VIP Database were searched to collect prospective or retrospective controlled studies on the combination of GCs and IVIG as the initial treatment of KD, which were published up to March 2016. Two investigators independently screened the literature, extracted data, and assessed the quality of the articles included. Then, a Meta analysis was performed using RevMan 5.2 software.

RESULTSA total of 11 articles in English were included, with 7 prospective studies and 4 retrospective studies. The results of the Meta analysis showed that compared with the group using IVIG alone, the combination group had a significantly lower incidence rate of coronary artery lesion (CAL) (OR=0.44, 95%CI 0.23-0.86, P=0.02) and a significantly shorter duration of fever (MD=-1.66, 95%CI -2.32 to -1.01, P<0.00001). The combination group had a significantly lower rate of no response to initial treatment than the IVIG alone group (OR=0.37, 95%CI 0.27-0.51, P<0.00001). The recurrence rate of KD and the incidence rate of adverse events showed no significant differences between the two groups.

CONCLUSIONSGCs combined with IVIG as the initial treatment for KD can reduce the incidence rate of CAL and the rate of no response to initial treatment and shorten the duration of fever, and does not increase the recurrence rate of KD and the incidence rate of adverse events.

Coronary Artery Disease ; prevention & control ; Drug Therapy, Combination ; Glucocorticoids ; administration & dosage ; Humans ; Immunoglobulins, Intravenous ; administration & dosage ; Mucocutaneous Lymph Node Syndrome ; drug therapy ; Recurrence

A 54-year-old Korean male with scleroderma-like manifestation of primary systemic amyloidosis presented with firm cutaneous induration of face and distal extremities, subcutaneous induration of the trunk and proximal extremities, limited range of motion in all joints, hoarseness, and dysphagia. Monthly high-dose intravenous immunoglobulin (hdIVIg) was given (three treatments, each time administering 0.4 g/kg per day for five days), and both signs and symptoms began to improve. However, the quantitative analyses of serum protein did not improve. Therapeutic plasma exchange (TPE) was performed monthly to clear the elevated serum immunoglobulin, and after several treatments, their levels normalized and symptoms were maintained in the improved state for more than two years. To summarize, hdIVIg and TPE combination therapy may be used as a safe first-line treatment for patients with primary systemic amyloidosis presenting with symptomatic monoclonal gammopathy.
Scleroderma, Systemic/diagnosis/etiology/*therapy ; *Plasma Exchange ; Middle Aged ; Male ; Immunoglobulins, Intravenous/administration & dosage/*therapeutic use ; Humans ; Combined Modality Therapy ; Amyloidosis/*complications

PURPOSE: The aim of this study was to evaluate the efficacy of low-dose oral methotrexate (MTX) as a treatment for patients with Kawasaki disease (KD) which was resistant to intravenous immunoglobulin (IVIG). PATIENTS AND METHODS: The patients who had persistent or recrudescent fever after treatment with IVIG were subsequently treated with low-dose oral MTX [10mg/body surface area (BSA)] once weekly. RESULTS: Seventeen patients developed persistent or recrudescent fever after treatment of KD with IVIG and were consequently given MTX. The proportion of children with coronary artery lesions (CALs) was 76%. The median value of maximum body temperatures decreased significantly within 24 hours of MTX therapy (38.6degrees C vs. 37.0degrees C, p < 0.001). The median CRP (C-reactive protein) level was found to be significantly lower 1 week after administering the first dose of MTX (8.9mg/dL vs. 1.2mg/dL, p < 0.001). The median duration of fever before MTX treatment was shorter in CALs (-) group than in CALs (+) group (7 days vs. 10 days, p = 0.023). No adverse effects of MTX were observed. CONCLUSION: MTX treatment for IVIG-resistant KD resulted in quick resolution of fever and rapid improvement of inflammation markers without causing any adverse effects. MTX therapy should further be assessed in a multicenter, placebo-blinded trial to evaluate whether it also improves coronary artery outcome.
Child ; Child, Preschool ; Drug Resistance ; Female ; Humans ; Immunoglobulins, Intravenous/*therapeutic use ; Infant ; Male ; Methotrexate/administration & dosage/*therapeutic use ; Mucocutaneous Lymph Node Syndrome/*drug therapy ; Treatment Outcome

OBJECTIVEThe aim of the study was to review the cases of Kawasaki Disease (KD) and analyze the clinical features especially their cardiac complications.

METHODSTotally 283 patients with KD were hospitalized from 1992 to 2002. Their clinical features and factors associated with increased risk of coronary artery aneurysms were reviewed.

RESULTS(1) Among the 283 KD patients, 186 were male and 97 were female. The male-female ratio was 1.9:1. Most of them (71%) were younger than 3 years old. Seasonal peak was in spring and summer (from May to Aug). Depending on the criteria of KD, 228 (81%) were diagnosed as typical KD and 55 (19.4%) were atypical KD. All patients had fever, lasting for 6.1 days. The most common clinical features were oral mucosal changes (97.5%) and cervical lymphadenopathy (95.4%), conjunctivitis (91.2%). And changes in the extremities (89.8%) and rash (81.5%) were also noted. (2) Before the treatment, coronary artery abnormalities were seen in 103/279 (36.9%), which occurred within 4 - 30 days of fever onset. Two weeks after intravenous gamma globulin (IVIG) treatment, the new cases of coronary artery abnormalities were 28/211 (13.3%). The prevalence of coronary artery aneurysms (CAA) with KD was 4.7%. The risk factors of CAA were male cases (P < 0.05) and fever lasting longer than 9 days (P < 0.05). Other cardiac abnormalities in acute phase included left atrial and ventricular enlargement (40/279, 14.3%) and changes in ECG (57/274, 20.8%). The pericardial effusions were found in 11 cases (3.9%).

CONCLUSIONSCardiac complications of KD occurred in the early period of KD. The new cases of coronary artery abnormalities were 13.3% after IVIG treatment. The risk factors of CAA included male cases and fever lasting for longer time.

Child, Preschool ; Coronary Aneurysm ; epidemiology ; etiology ; Female ; Heart Diseases ; diagnosis ; etiology ; Humans ; Immunoglobulins, Intravenous ; administration & dosage ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; diagnosis ; drug therapy ; Prevalence ; Risk Factors