Massolo F, Flori C, Cellini M, Baraldi C, Iori G
Istituto di Clinica Pediatrica, Università degli Studi di Modena, Italia.
Pediatr Med Chir. 1994 Jan-Feb;16(1):37-41.
High-dose intravenous immunoglobulin play a critical role in a lot of pediatric hematologic diseases. In our experience we studied the effects of IVIG treatment in 63 children. They all tolerated IVIG preparations in every infusions; no trouble caused the interruption of treatment. The efficacy is evident in immunomediated diseases, most of all ITP, and controlling septic episodes in immunocompromised patients (ALL, AIDS, marrow bone transplantation). An important problem is the cost of preparation; but we may consider that this treatment, for example in ITP, reduces hospitalization for children, necessity of platelets' transfusions, use of steroids and, therefore, their collateral effects. Hence, we assert that the social cost of the management of ITP disease is not higher in children treated with IVIG. Furthermore, short hospitalization for IVIG therapy contributes to accept this disease. It should be advisable to make controlled studies to define with more accuracy the role of this preparation and the modality of its use in the different clinical conditions in which it is employed.
大剂量静脉注射免疫球蛋白在许多儿科血液疾病中起着关键作用。根据我们的经验，我们研究了静脉注射免疫球蛋白治疗对63名儿童的影响。他们在每次输注中都能耐受静脉注射免疫球蛋白制剂；没有因任何问题导致治疗中断。其疗效在免疫介导的疾病中很明显，尤其是免疫性血小板减少性紫癜（ITP），并且在免疫功能低下的患者（急性淋巴细胞白血病、艾滋病、骨髓移植）中能控制败血症发作。一个重要的问题是制剂的成本；但我们可以认为，例如在ITP治疗中，这种疗法减少了儿童的住院时间、血小板输注的必要性、类固醇的使用以及因此产生的副作用。因此，我们断言，接受静脉注射免疫球蛋白治疗的儿童中，ITP疾病管理的社会成本并不更高。此外，静脉注射免疫球蛋白治疗的短期住院有助于患者接受这种疾病。建议进行对照研究，以更准确地确定这种制剂的作用及其在不同临床应用中的使用方式。
