Hara Masako
Institute of Rheumatology, Tokyo Women's Medical University.
Nihon Rinsho. 2009 Mar;67(3):599-605.
Intravenous immunoglobulin (VIG) was given by Imbach in 1981 to idiopathic thrombocytopenic purpura (ITP). The cure of many of the patients in response to the IVIG expanded the use of IVIG to other autoimmune condition. The diseases proven the efficacy of VIG by controlled trial were ITP, Guillain-Barré syndrome, chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), multiple motor neuropathy, multiple sclerosis, myasthenia gravis, ANCA related vasculitis, Kawasaki disease, autoimmune uveitis and dermatomyositis. There are several uncontrolled trials and case reports about the efficacy of IVIG on the connective tissue diseases, such as systemic lupus erythematosus, systemic sclerosis, Sjögren syndrome, antiphospholipid antibody syndrome and Still's disease. In Japan, only ITP, Kawasaki disease and CIDP are allowed to be use IVIG by health insurance. I would like to summarize the application of VIG on collagen diseases and refer both novel mechanisms as well as to complications of this therapy.
1981年,因巴赫将静脉注射免疫球蛋白(VIG)用于特发性血小板减少性紫癜(ITP)的治疗。许多患者因静脉注射免疫球蛋白而治愈,这使得静脉注射免疫球蛋白在其他自身免疫性疾病中的应用得以拓展。经对照试验证实静脉注射免疫球蛋白有效的疾病有特发性血小板减少性紫癜、格林-巴利综合征、慢性炎症性脱髓鞘性多发性神经根神经病(CIDP)、多灶性运动神经病、多发性硬化症、重症肌无力、抗中性粒细胞胞浆抗体相关性血管炎、川崎病、自身免疫性葡萄膜炎和皮肌炎。关于静脉注射免疫球蛋白对结缔组织病(如系统性红斑狼疮、系统性硬化症、干燥综合征、抗磷脂抗体综合征和斯蒂尔病)疗效的研究,有一些非对照试验和病例报告。在日本,医疗保险仅允许将静脉注射免疫球蛋白用于特发性血小板减少性紫癜、川崎病和慢性炎症性脱髓鞘性多发性神经根神经病的治疗。我将总结静脉注射免疫球蛋白在胶原病中的应用,并介绍该疗法的新机制及并发症。