Streu Erin, Wiseman Marni C, Johnston James B
Research Institute of Hematology and Oncology, CancerCare Manitoba, Winnipeg, MB, Canada.
Section of Dermatology, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada.
SAGE Open Med Case Rep. 2020 Jan 21;8:2050313X19901071. doi: 10.1177/2050313X19901071. eCollection 2020.
Intravenous immunoglobulin is a recognized treatment in recalcitrant autoimmune bullous diseases. Infusions are administered monthly over 1-5 days in the hospital setting and associated with mild to severe infusion-related systemic effects, in part due to the high doses necessary to induce and achieve remission. We present a case series of four patients with bullous diseases treated successfully with low-dose subcutaneous IgG who achieved remission with maintenance therapy. Patient-administered smaller, more frequent doses of IgG into subcutaneous tissue more closely mimics the body's own antibody production and produces a more stable serum trough level. Subcutaneous IgG is a novel treatment approach in bullous diseases which can induce a state remission.
静脉注射免疫球蛋白是治疗顽固性自身免疫性大疱性疾病的一种公认疗法。在医院环境中，每月输注1 - 5天，会伴有轻度至重度的输液相关全身反应，部分原因是诱导和实现缓解所需的高剂量。我们报告了一组4例大疱性疾病患者的病例系列，他们通过低剂量皮下注射免疫球蛋白（IgG）成功治疗并通过维持治疗实现缓解。患者自行给予皮下组织较小且更频繁剂量的IgG更接近人体自身抗体产生，并产生更稳定的血清谷浓度。皮下注射IgG是大疱性疾病中一种可诱导缓解状态的新型治疗方法。
