Wittstock Matthias, Benecke Reiner, Zettl Uwe K
Department of Neurology, University of Rostock, Rostock, Germany.
Eur Neurol. 2003;50(3):172-5. doi: 10.1159/000073059.
Therapy with intravenous immunoglobulins (IVIG) is thought to be a safe treatment for a number of immune-mediated neurological diseases. Published data about prevalence of adverse effects range from 11 to 81%. The purpose of our study was to present a representative view on adverse effects by analysis of a large cohort of patients treated by IVIG. In a prospective study, we analysed 117 patients (age 17-79 years) who were treated with IVIG for various neurological diseases including chronic inflammatory demyelinating polyneuropathy, diabetic amyotrophy, inclusion body myositis, multiple sclerosis, Guillain-Barré syndrome, Miller-Fisher syndrome, multifocal motor neuropathy, myasthenia gravis and polymyositis. IVIG therapy was applied at a dose of 0.4 g/kg body weight/day in a total of 408 therapy courses. 42.7% showed adverse events. The majority of patients presented with minor adverse effects, mostly asymptomatic laboratory changes. Rash or mild headache occurred in 8 patients, especially when IVIG was given with infusion flow higher than 10 g/h. Two patients showed a severe complication with deep vein thrombosis. In summary, beside its effectiveness in immune mediated neurological diseases, therapy with IVIG seems to be a safe therapy. Most patients show no or minor adverse effects. Patients with pre-existent disorders like heart or renal insufficiency or immobilised patients, however, may be at higher risk for complications.
静脉注射免疫球蛋白（IVIG）疗法被认为是治疗多种免疫介导性神经疾病的安全疗法。已发表的关于不良反应发生率的数据在11%至81%之间。我们研究的目的是通过分析一大群接受IVIG治疗的患者，对不良反应呈现一个具有代表性的观点。在一项前瞻性研究中，我们分析了117例患者（年龄17 - 79岁），他们因各种神经疾病接受IVIG治疗，包括慢性炎症性脱髓鞘性多发性神经病、糖尿病性肌萎缩、包涵体肌炎、多发性硬化症、格林 - 巴利综合征、米勒 - 费希尔综合征、多灶性运动神经病、重症肌无力和多发性肌炎。IVIG治疗的剂量为0.4 g/kg体重/天，共进行了408个疗程。42.7%的患者出现了不良事件。大多数患者出现轻微不良反应，主要是无症状的实验室指标变化。8例患者出现皮疹或轻度头痛，尤其是在IVIG输注速度高于10 g/h时。2例患者出现严重并发症，即深静脉血栓形成。总之，除了在免疫介导性神经疾病中的有效性外，IVIG治疗似乎是一种安全的疗法。大多数患者没有或仅有轻微不良反应。然而，患有心脏或肾功能不全等既往疾病的患者或长期卧床的患者可能发生并发症的风险更高。
