Dawn G, Urcelay M, Ah-Weng A, O'Neill S M, Douglas W S
Department of Dermatology, Monklands Hospital, Airdrie, Lanarkshire, ML6 0JS, U.K.
Br J Dermatol. 2003 Oct;149(4):836-40. doi: 10.1046/j.1365-2133.2003.05486.x.
Delayed pressure urticaria (DPU) is difficult to treat. High-dose intravenous immunoglobulin (IVIG) has been found to be effective in treating patients with autoimmune chronic urticaria.
To report the effect of IVIG on eight patients with severe unremitting DPU.
IVIG was administered at a dose of 2 g kg-1 over 2-3 days on an in-patient basis. The response to treatment was assessed subjectively and recorded as remission, improved or unchanged. An autologous serum skin test (ASST) was performed in seven patients.
Three of eight patients achieved remission; two after one infusion and one after three infusions. Two patients improved. Three patients remained unchanged; of these, two declined further treatment after two infusions, and one failed to improve after six infusions at monthly intervals. Four of seven patients had positive ASST; three responded to IVIG. Two developed delayed positive ASST; both responded to IVIG. Of three patients with negative ASST, two responded.
IVIG induced remission or improved symptoms in five of eight patients with DPU with severe unremitting disease who had failed to respond to other therapies or were controlled only with systemic corticosteroids. Those who responded did so with three or fewer infusions. ASST is not a reliable predictor of response to IVIG.
迟发性压力性荨麻疹（DPU）难以治疗。已发现高剂量静脉注射免疫球蛋白（IVIG）对自身免疫性慢性荨麻疹患者有效。
报告IVIG对8例严重顽固性DPU患者的疗效。
住院期间，以2 g/kg的剂量在2 - 3天内静脉输注IVIG。主观评估治疗反应并记录为缓解、改善或未改变。对7例患者进行了自体血清皮肤试验（ASST）。
8例患者中有3例达到缓解；2例在一次输注后缓解，1例在三次输注后缓解。2例患者病情改善。3例患者病情未改变；其中2例在两次输注后拒绝进一步治疗，1例在每月一次间隔输注六次后仍未改善。7例患者中有4例ASST呈阳性；3例对IVIG有反应。2例出现延迟性ASST阳性；均对IVIG有反应。3例ASST阴性的患者中，2例有反应。
IVIG使8例严重顽固性DPU患者中的5例病情缓解或症状改善，这些患者对其他治疗无反应或仅用全身性皮质类固醇控制病情。有反应的患者在三次或更少次数的输注后出现疗效。ASST不是IVIG治疗反应的可靠预测指标。
