Rodriguez Martha M, Wagner-Weiner Linda
Pediatr Ann. 2017 Jan 1;46(1):e19-e24. doi: 10.3928/19382359-20161214-01.
Intravenous immunoglobulin (IVIG) is given to children with a variety of rheumatologic illnesses. The mechanism of action by which it exerts therapeutic effects is not well understood and likely differs in the medical conditions for which it is given. IVIG is approved by the US Food and Drug Administration and is the standard of care for Kawasaki disease, but most IVIG use in pediatric rheumatology is "off-label. " The literature supports the use of IVIG for juvenile dermatomyositis, although it is unclear whether its use should be limited to those children with more severe or refractory disease. It appears efficacious in the treatment of autoimmune thrombocytopenia secondary to lupus, but its use may be limited by transient responses. Treatment of other categories of pediatric rheumatologic diseases, such as juvenile idiopathic arthritis and non-Kawasaki vasculitides, is not well-established in the literature. This review focuses on current use of IVIG in the treatment of pediatric rheumatologic disorders. [Pediatr Ann. 2017;46(1):e19-e24.].
静脉注射免疫球蛋白（IVIG）用于患有多种风湿性疾病的儿童。其发挥治疗作用的机制尚不完全清楚，并且在其适用的医疗状况下可能有所不同。IVIG已获得美国食品药品监督管理局的批准，是川崎病的标准治疗方法，但在儿科风湿病中，大多数IVIG的使用属于“超说明书用药”。文献支持将IVIG用于青少年皮肌炎，尽管尚不清楚其使用是否应限于病情更严重或难治的儿童。它似乎对狼疮继发的自身免疫性血小板减少症有效，但其使用可能受到短暂反应的限制。在文献中，对于其他类别的儿科风湿性疾病，如幼年特发性关节炎和非川崎病性血管炎，其治疗方法尚未明确确立。本综述重点关注IVIG目前在儿科风湿性疾病治疗中的应用。[《儿科年鉴》。2017年；46(1):e19 - e24。]
