Farmacoriflessioni
Utilizzo delle immunoglobuline endovenose nella pratica clinica in pediatria
INTRAVENOUS IMMUNOGLOBULINE IN PAEDIATRICS
Giovanna Ventura1, Marco Rabusin2, Elena Spinelli3, Raffaele Badolato3
1Clinica Pediatrica, Università di Trieste; 2Unità Operativa di Emato-Oncologia, IRCCS “Burlo Garofolo”, Trieste
3Clinica Pediatrica, Università di Brescia
Giugno 2009 - pagg. 371 -381
Abstract
Intravenous immunoglobuline is a blood product prepared from the serum of between
1,000 and 15,000 donors per batch. It is the treatment indicated for patients with antibody
deficiencies and it is used in replacement doses of 200-400 mg/kg. In contrast, high IVIg
doses generally given at 2 g/kg are used as immunomodulatory agent in an increasing
number of immune and inflammatory disorders such as: immune thrombocytopenic purpura,
Kawasaki syndrome, dermatomyositis, toxic epidermal necrolysis, autoimmune neurological
diseases as Guillain-Barré syndrome and chronic inflammatory demyelinating
polyneuropathy, and post bone marrow transplantation. In the paper the Authors review
recent development in the understanding of the mechanism of action of IVIg, the major current
clinical applications and the most common side effects.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
1. Falcini F, Cimaz R, Calabri GB, et al. Kawasaki’s
disease in northern Italy: a multicenter
retrospective study of 250 patients. Clin Exp
Rheumatol 2002;20:421-6.
2. Oates-Whitehead RM, Baumer JH, Haines L, et al. Intravenous immunoglobulin for the treatment of Kawasaki disease in children. Cochrane Database Syst Rev 2003:CD004000.
3. Tse SM, Silverman ED, McCrindle BW, et al. Early treatment with intravenous immunoglobulin in patients with Kawasaki disease. J Pediatr 2002;140:450-5.
4. Jibiki T, Terai M, Kurosaki T, et al. Efficacy of intravenous immune globulin therapy combined with dexamethasone for the initial treatment of acute Kawasaki disease. Eur J Pediatr 2004;163:229-33.
5. Inoue Y, Okada Y, Shinohara M, et al. A multicenter prospective randomized trial of corticosteroids in primary therapy for Kawasaki disease: clinical course and coronary artery outcome. J Pediatr 2006;149:336-41.
6. Moreno N, Méndez-Echevarrìa A, de Inonencio J, et al. Coronary involvement in infants with Kawasaki disease treated with intravenous gamma-globulin. Pediatr Cardiol 2008;29:31-5.
7. Geddes M, Storek J. Immune reconstitution following hematopoietic stem-cell transplantation. Best Pract Res Clin Haematol 2007; 20:329-48.
8. Sokos DR, Berger M, Lazarus HM. Intravenous immunoglobulin: appropriate indications and uses in hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2002;8:117-30.
9. Sullivan KM. Immunomodulation in allogeneic marrow transplantation: use of intravenous immune globulin to suppress acute graftversus- host disease. Clin Exp Immunol 1996; 104(Suppl 1):43-8.
10. Cordonnier C, Chevret S, Legrand M, et al. Should immunoglobuline therapy be used in allogeneic stem cell transplantation? Ann Intern Med 2003;139:8-18.
11. Winston DJ, Antin JH, Wolff SN, et al. A multicenter randomized double blind comparison of different doses of intravenous immunoglobulin for prevention of graft-versus-host disease and infection after bone marrow transplantation. Bone Marrow Transplant 2001;28: 187-96.
12. Imbach P, Barandun S, d’Apuzzo V, et al. High-dose intravenous gammaglobulin for idio-pathic thrombocytopenic purpura in childhood. Lancet 1981;1:1228-31.
13. Fehr J, Hofmann V, Kappeler U. Transient reversal of thrombocytopenia in idiopatic throm- bocytopenic purpura by high dose intravenous gamma globulin. N Engl J Med 1982;
14. Bruhns P, Samuelsson A, Pollard JW, et al. Colony-stimulating factor-1-dependent macrophages are responsible for IVIg protection in antibody-induced autoimmune disease. Immunity 2003;18:573-81.
15. Kaveri SV, Lacroix-Desmazes S, Bayry J. The Antiinflammatory IgG. N Engl J Med 2008;359:307-9.
16. Treutiger I, Rajantie J, Zeller B, et al. Does treatment of newly diagnosed idiopathic throm- bocytopenic purpura reduce morbidity? Arch Dis Child 2007;92:704-7.
17. Blanchette VS, Luke B, Andrew M, et al. A prospective, randomized trial of high dose intravenous immune globulin G therapy, oral prednisone therapy, and no therapy in childhood acute immune thrombocytopenic purpura. J Pediatr 1993;123:989-95.
18. Erduran E, Aslan Y, Gedik Y, Orhan F. A randomized and comparative study of intravenous immunoglobulin and mega dose methylprednisolone treatments in children with acute idio-pathic thrombocytopenic purpura. Turk J Pediatr 2003;45:295-300.
19. Ancona KG, Parker RI, Atlas MP, Prakash D. Randomized trial of high-dose methylpredni- solone versus intravenous immunoglobulin for the treatment of acute idiopathic thrombocytopenic purpura in children. J Pediatr Hematol Oncol 2002;24:540-4.
20. Hedlund-Treutiger I, Henter JI, Elinder G. Randomized study of IVIg and high-dose dexamethasone therapy for children with chronic idiopathic thrombocytopenic purpura. J Pediatr Hematol Oncol 2003;25:139-44.
21. Blanchette VS, Imbach P, Andrew M, et al. Randomized trial of intravenous immunoglobulin G, intravenous anti-D, and oral prednisone in childhood acute immune thrombocytopenic purpura. Lancet 1994;344:703-7.
22. El Afy MS, Mokhtar GM, El-Laboudy MA, et al. Randomized trial of anti-D immunoglobulin versus low-dose intravenous immunoglobulin in the treatment of childhood chronic idiopathic thrombocytopenic purpura. Acta Haematol 2006;115:46-52.
23. Bennett CL, Weinberg PD, Golub RM, Bussel JB. The potential for treatment of idiopathic thrombocytopenic purpura with anti-D to prevent splenectomy: a predictive cost analysis. Semin Hematol 2000;37:26-30.
24. Cooper N, Woloski BM, Fodero EM, et al. Does treatment with intermittent infusions of in-travenous anti-D allow a proportion of adults with recently diagnosed immune thrombocy- topenic purpura to avoid splenectomy? Blood 2002;99:1922-7.
25. van der Meché FGA, Schimtz PM, Dutch Guillain-Barré Study Group. A randomized trial comparing intravenous immune globulin and plasma exchange in Guillain-Barré syndrome. N Engl J Med 1992;326:1123-9.
26. Hughes RA, Raphael JC, Swan AV, et al. Intravenous immunoglobulin for Guillain-Barré syndrome. Cochrane Database Syst Rev 2004: CD002063.
27. van Koningsveld R, Schmitz PI, Meche FG, et al. Effect of methyl-prednisolone when added to standard treatment with intravenous immunoglobulin gor Guillain-Barré syndrome: randomized trial. Lancet 2004;363:192-6.
28. Kreimann KG, de Heer G, Nierhaus A, Kluge S. Use of polyclonal immunoglobulins as ad-junctive therapy for sepsis or septic shock. Critic Care Med 2007;23:665-70.
29. Ohlsson A, Lacy JB. Intravenous immunoglobulin for preventing infection in preterm and/or low birth-weight infants. Cochrane Database Syst Rev 2004:CD000361.
30. Darenberg J, Ihendyane N, Sjolin J, Aufwerber E. Intravenous immunoglobulin G therapy in sreptococcal toxic shock syndrome: a European randomized, double blind, placebo-controlled trial. Clin Infect Dis 2003; 37:333-40.
31. Douzinas EE, Pitardis MT, Louris G. Prevention of infection in multiple trauma patients by high-dose intravenous immunoglobulins. Critic Care Med 2000;28:8-15.
32. Kaul R, McGeer A, Norrby-Teglund A, Kotb M, Schwartz B, O’Rourke K. Intravenous immunoglobulin therapy for streptococcal toxic shock syndrome-a comparative observational study. The Canadian Streptococcal Study group. Clin Infect Dis1999;28:800-7.
33. Dalakas MC, Illa I, Dambrosia JM, et al. A controlled trial of high-dose intravenous immune globulin infusions as treatment for dermatomyositis. N Engl J Med 1993;329:1993- 2000.
34. Dalakas MC. The role of high-dose immune globulin intravenous in the treatment of dermatomyositis. Int Immunopharmacol 2006;6:550-6.
35. Manlhiot C, Tyrell PN, Liang L, Atkinsin AR, Lau W, Feldman BM. Safety of intravenous immunoglobulin in the treatment of juvenile dermatomyositis: adverse reactions are associated with immunoglobulin A content. Pediatrics 2008;121:e626-30.
36. Feldman BM, Rider LG, Reed AM, Pachman LM. Juvenile dermatomyositis and other idio-pathic inflammatory myopathies of childhood. Lancet 2008;371:2201-12.
37. Hauser SL, Waubant E, Arnold DL, et al. and HERMES Trial Group. B-cell depletion with rituximab in relapsing-remitting multiple sclerosis. N Engl J Med 2008;14;358:676-88.
38. Pöhlau D, Przuntek H, Sailer M, et al. Intravenous immunoglobulin in primary and secondary chronic progressive multiple sclerosis: a randomized placebo controlled multicentre study. Mult Scler 2007;13:1107-17.
39. Fazekas F, Sørensen PS, Filippi M, et al.; ESIMS. MRI results from the European Study on Intravenous Immunoglobulin in Secondary Progressive Multiple Sclerosis (ESIMS). Mult Scler 2005;11:433-40.
40. Achiron A, Kishner I, Sarova-Pinhas I, et al. Intravenous immunoglobulin treatment following the first demyelinating event suggestive of multiple sclerosis: a randomized, doubleblind, placebo-controlled trial. Arch Neurol 2004;61:1515-20.
41. Isobe Y, Sugimoto K, Shiraki Y, et al. Successful high-titer immunoglobulin therapy for persistent parvovirus B19 infection in a lymphoma patient treated with rituximabcombined chemotherapy. Am J Hematol 2004; 77:370-3.
42. Tang JW, Lau JS, Wong SY, et al. Dose-bydose virological and hematological responses to intravenous immunoglobulin in an immunocompromised patient with persistent parvovirus B19 infection. J Med Virol 2007;79: 1401-5.
43. Mouthon L, Guillevin L, Tellier Z. Intravenous immunoglobulins in autoimmune-or parvovirus B19-mediated pure red-cell aplasia. Autoimmun Rev 2005;4:264-9.
44. Koduri PR, Kumapley R, Valladares J, Teter C. Chronic pure red cell aplasia caused by par-vovirus B19 in AIDS: use of intravenous immunoglobulin-a report of eight patients. Am J Hematol 1999;61:16-20.
45. Viard I, Wehrli P, Bullani R, et al. Inhibition of toxic epidermal necrolysis by blockade of CD95 with human intravenous immunoglobulin. Science 1998;282:490-3.
46. Campione E, Marulli GC, Carrozzo AM, et al. High dose intravenous immunoglobulin for severe drug reactions: efficacy in toxic epidermal necrolysis. Acta Derm Venereol 2003; 83:430-2.
47. Prins C, Kerdel FA, Padilla RS, et al. Treatment of toxic epidermal necrolysis with high dose intravenous immunoglobulins: multicenter retrospective analysis of 48 consecutive cases. Arch Dermatol 2003;139:26-32.
48. Gottstein R, Cooke RW. Systematic review of intravenous immunoglobulin in haemolytic disease of the newborn. Arch Dis Child Fetal Neonatal Ed 2003;88:F6-10.
49. Alcock GS, Liley H. Immunoglobulin infusion for isoimmune haemolytic jaundice in neonates. Cochrane Database Syst Rev 2002; (3):CD003313.
50. Kiefel V, Bassler D, Kroll H, et al. Antigenpositive platelet transfusion in neonatal alloimmune thrombocytopenia (NAIT). Blood 2006;107:3761-3.
51. Kaplan C. Neonatal alloimmune thrombocytopenia. Haematologica 2008;93:805-7.
52. Martinez V, Cohen P, Pagnoux C, et al.; French Vasculitis Study Group. Intravenous immu-noglobulins for relapses of systemic vasculitides associated with antineutrophil cytoplasmic autoantibodies: results of a multicenter, prospective, open-label study of twentytwo patients. Arthritis Rheum 2008;58:308-17.
53. Jayne DR, Lockwood CM. Intravenous immunoglobulin as sole therapy for systemic vascu- litis. Br J Rheumatol 1996;35:1150-3.
54. Richter C, Schnabel A, Csernok E, De Groot K, Reinhold-Keller E, Gross WL. Treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated systemic vasculitis with high-dose intravenous immunoglobulin. Clin Exp Immunol 1995;101:2-7.
55. Hughes R, Bensa S, Willison H, et al. Randomized controlled trial of intravenous immuno- globulin versus oral prednisolone in chronic inflammatory demyelinating polyradiculoneu- ropathy. Ann Neurol 2001;50:195-201.
56. Hughes RA, Donofrio P, Bril V, et al. Intravenous immune globulin (10% caprylate-chromatography purified) for the treatment of chronic inflammatory demyelinating polyra-diculoneuropathy (ICE study): a randomised placebo-controlled trial. Lancet Neurol 2008;7: 136-44.
57. Robinson J. Hartling L. Vandermeer B, Crumley E, Klassen TP. Intravenous immunoglobulin for presumed viral myocarditis in children and adults. Cochrane Database Syst Rev 2005;25:CD004370.
58. Hamrock DJ. Adverse events associated with intravenous immunoglobulin therapy. Int Im-munopharmacol 2006;4:535-42.
59. Sekul EA, Cupler EJ, Dalakas MC. Aseptic meningitis associated with high-dose intravenous immunoglobulin therapy: frequency and risk factors. Ann Intern Med 1994;121:259-62.
60. Kato E, Shindo S, Eto Y, Hashimoto N, Yamamoto M, Sakata Y, Hiyoshi Y. Administration of immune globulin associated with aseptic meningitis. JAMA 1988;259:3269-71.
61. Casteels-Van Daele M, Wijndaele L, Hanninck K, Gillis P. Intravenous immune globulin and acute aseptic meningitis. N Engl J Med 1990;323:614-5.
62. Kattamis AC, Shankar S, Cohen AR. Neurologic complications of treatment of childhood acute immune thrombocytopenic purpura with intravenously administered immunoglobulin G. J Pediatr 1997;130:281-3.
63. Rao SP, Teitlebaum J, Miller ST. Intravenous immune globulin and aseptic meningitis. Am J Dis Child 1992;146:539-40.
64. Burks AW, Sampson HA, Buckley RH. Anaphylactic reactions after gamma globulin ad-ministration in patients with hypogammaglobulinemia. Detection of IgE antibodies to IgA. N Engl J Med 1986;314:560-4.
65. McCluskey DR, Boyd NA Anaphylaxis with intravenous gammaglobulin. Lancet 1990;336:874.
66. Bachmann R. Studies on the serum gamma- A-globulin level. 3. The frequency of Agamma- A-globulinemia. Scand J Clin Lab Invest 1965;17:316-20.
67. Hammarström L, Persson MA, Smith CI. Anti-IgA in selective IgA deficiency. In vitro effects and Ig subclass pattern of human anti- IgA. Scand J Immunol 1983;18:509-13.
68. Caress JB, Cartwright MS, Donofrio PD, Peacock JE Jr. The clinical features of 16 cases of stroke associated with administration of IVIg. Neurology 2003;60:1822-4.
2. Oates-Whitehead RM, Baumer JH, Haines L, et al. Intravenous immunoglobulin for the treatment of Kawasaki disease in children. Cochrane Database Syst Rev 2003:CD004000.
3. Tse SM, Silverman ED, McCrindle BW, et al. Early treatment with intravenous immunoglobulin in patients with Kawasaki disease. J Pediatr 2002;140:450-5.
4. Jibiki T, Terai M, Kurosaki T, et al. Efficacy of intravenous immune globulin therapy combined with dexamethasone for the initial treatment of acute Kawasaki disease. Eur J Pediatr 2004;163:229-33.
5. Inoue Y, Okada Y, Shinohara M, et al. A multicenter prospective randomized trial of corticosteroids in primary therapy for Kawasaki disease: clinical course and coronary artery outcome. J Pediatr 2006;149:336-41.
6. Moreno N, Méndez-Echevarrìa A, de Inonencio J, et al. Coronary involvement in infants with Kawasaki disease treated with intravenous gamma-globulin. Pediatr Cardiol 2008;29:31-5.
7. Geddes M, Storek J. Immune reconstitution following hematopoietic stem-cell transplantation. Best Pract Res Clin Haematol 2007; 20:329-48.
8. Sokos DR, Berger M, Lazarus HM. Intravenous immunoglobulin: appropriate indications and uses in hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2002;8:117-30.
9. Sullivan KM. Immunomodulation in allogeneic marrow transplantation: use of intravenous immune globulin to suppress acute graftversus- host disease. Clin Exp Immunol 1996; 104(Suppl 1):43-8.
10. Cordonnier C, Chevret S, Legrand M, et al. Should immunoglobuline therapy be used in allogeneic stem cell transplantation? Ann Intern Med 2003;139:8-18.
11. Winston DJ, Antin JH, Wolff SN, et al. A multicenter randomized double blind comparison of different doses of intravenous immunoglobulin for prevention of graft-versus-host disease and infection after bone marrow transplantation. Bone Marrow Transplant 2001;28: 187-96.
12. Imbach P, Barandun S, d’Apuzzo V, et al. High-dose intravenous gammaglobulin for idio-pathic thrombocytopenic purpura in childhood. Lancet 1981;1:1228-31.
13. Fehr J, Hofmann V, Kappeler U. Transient reversal of thrombocytopenia in idiopatic throm- bocytopenic purpura by high dose intravenous gamma globulin. N Engl J Med 1982;
14. Bruhns P, Samuelsson A, Pollard JW, et al. Colony-stimulating factor-1-dependent macrophages are responsible for IVIg protection in antibody-induced autoimmune disease. Immunity 2003;18:573-81.
15. Kaveri SV, Lacroix-Desmazes S, Bayry J. The Antiinflammatory IgG. N Engl J Med 2008;359:307-9.
16. Treutiger I, Rajantie J, Zeller B, et al. Does treatment of newly diagnosed idiopathic throm- bocytopenic purpura reduce morbidity? Arch Dis Child 2007;92:704-7.
17. Blanchette VS, Luke B, Andrew M, et al. A prospective, randomized trial of high dose intravenous immune globulin G therapy, oral prednisone therapy, and no therapy in childhood acute immune thrombocytopenic purpura. J Pediatr 1993;123:989-95.
18. Erduran E, Aslan Y, Gedik Y, Orhan F. A randomized and comparative study of intravenous immunoglobulin and mega dose methylprednisolone treatments in children with acute idio-pathic thrombocytopenic purpura. Turk J Pediatr 2003;45:295-300.
19. Ancona KG, Parker RI, Atlas MP, Prakash D. Randomized trial of high-dose methylpredni- solone versus intravenous immunoglobulin for the treatment of acute idiopathic thrombocytopenic purpura in children. J Pediatr Hematol Oncol 2002;24:540-4.
20. Hedlund-Treutiger I, Henter JI, Elinder G. Randomized study of IVIg and high-dose dexamethasone therapy for children with chronic idiopathic thrombocytopenic purpura. J Pediatr Hematol Oncol 2003;25:139-44.
21. Blanchette VS, Imbach P, Andrew M, et al. Randomized trial of intravenous immunoglobulin G, intravenous anti-D, and oral prednisone in childhood acute immune thrombocytopenic purpura. Lancet 1994;344:703-7.
22. El Afy MS, Mokhtar GM, El-Laboudy MA, et al. Randomized trial of anti-D immunoglobulin versus low-dose intravenous immunoglobulin in the treatment of childhood chronic idiopathic thrombocytopenic purpura. Acta Haematol 2006;115:46-52.
23. Bennett CL, Weinberg PD, Golub RM, Bussel JB. The potential for treatment of idiopathic thrombocytopenic purpura with anti-D to prevent splenectomy: a predictive cost analysis. Semin Hematol 2000;37:26-30.
24. Cooper N, Woloski BM, Fodero EM, et al. Does treatment with intermittent infusions of in-travenous anti-D allow a proportion of adults with recently diagnosed immune thrombocy- topenic purpura to avoid splenectomy? Blood 2002;99:1922-7.
25. van der Meché FGA, Schimtz PM, Dutch Guillain-Barré Study Group. A randomized trial comparing intravenous immune globulin and plasma exchange in Guillain-Barré syndrome. N Engl J Med 1992;326:1123-9.
26. Hughes RA, Raphael JC, Swan AV, et al. Intravenous immunoglobulin for Guillain-Barré syndrome. Cochrane Database Syst Rev 2004: CD002063.
27. van Koningsveld R, Schmitz PI, Meche FG, et al. Effect of methyl-prednisolone when added to standard treatment with intravenous immunoglobulin gor Guillain-Barré syndrome: randomized trial. Lancet 2004;363:192-6.
28. Kreimann KG, de Heer G, Nierhaus A, Kluge S. Use of polyclonal immunoglobulins as ad-junctive therapy for sepsis or septic shock. Critic Care Med 2007;23:665-70.
29. Ohlsson A, Lacy JB. Intravenous immunoglobulin for preventing infection in preterm and/or low birth-weight infants. Cochrane Database Syst Rev 2004:CD000361.
30. Darenberg J, Ihendyane N, Sjolin J, Aufwerber E. Intravenous immunoglobulin G therapy in sreptococcal toxic shock syndrome: a European randomized, double blind, placebo-controlled trial. Clin Infect Dis 2003; 37:333-40.
31. Douzinas EE, Pitardis MT, Louris G. Prevention of infection in multiple trauma patients by high-dose intravenous immunoglobulins. Critic Care Med 2000;28:8-15.
32. Kaul R, McGeer A, Norrby-Teglund A, Kotb M, Schwartz B, O’Rourke K. Intravenous immunoglobulin therapy for streptococcal toxic shock syndrome-a comparative observational study. The Canadian Streptococcal Study group. Clin Infect Dis1999;28:800-7.
33. Dalakas MC, Illa I, Dambrosia JM, et al. A controlled trial of high-dose intravenous immune globulin infusions as treatment for dermatomyositis. N Engl J Med 1993;329:1993- 2000.
34. Dalakas MC. The role of high-dose immune globulin intravenous in the treatment of dermatomyositis. Int Immunopharmacol 2006;6:550-6.
35. Manlhiot C, Tyrell PN, Liang L, Atkinsin AR, Lau W, Feldman BM. Safety of intravenous immunoglobulin in the treatment of juvenile dermatomyositis: adverse reactions are associated with immunoglobulin A content. Pediatrics 2008;121:e626-30.
36. Feldman BM, Rider LG, Reed AM, Pachman LM. Juvenile dermatomyositis and other idio-pathic inflammatory myopathies of childhood. Lancet 2008;371:2201-12.
37. Hauser SL, Waubant E, Arnold DL, et al. and HERMES Trial Group. B-cell depletion with rituximab in relapsing-remitting multiple sclerosis. N Engl J Med 2008;14;358:676-88.
38. Pöhlau D, Przuntek H, Sailer M, et al. Intravenous immunoglobulin in primary and secondary chronic progressive multiple sclerosis: a randomized placebo controlled multicentre study. Mult Scler 2007;13:1107-17.
39. Fazekas F, Sørensen PS, Filippi M, et al.; ESIMS. MRI results from the European Study on Intravenous Immunoglobulin in Secondary Progressive Multiple Sclerosis (ESIMS). Mult Scler 2005;11:433-40.
40. Achiron A, Kishner I, Sarova-Pinhas I, et al. Intravenous immunoglobulin treatment following the first demyelinating event suggestive of multiple sclerosis: a randomized, doubleblind, placebo-controlled trial. Arch Neurol 2004;61:1515-20.
41. Isobe Y, Sugimoto K, Shiraki Y, et al. Successful high-titer immunoglobulin therapy for persistent parvovirus B19 infection in a lymphoma patient treated with rituximabcombined chemotherapy. Am J Hematol 2004; 77:370-3.
42. Tang JW, Lau JS, Wong SY, et al. Dose-bydose virological and hematological responses to intravenous immunoglobulin in an immunocompromised patient with persistent parvovirus B19 infection. J Med Virol 2007;79: 1401-5.
43. Mouthon L, Guillevin L, Tellier Z. Intravenous immunoglobulins in autoimmune-or parvovirus B19-mediated pure red-cell aplasia. Autoimmun Rev 2005;4:264-9.
44. Koduri PR, Kumapley R, Valladares J, Teter C. Chronic pure red cell aplasia caused by par-vovirus B19 in AIDS: use of intravenous immunoglobulin-a report of eight patients. Am J Hematol 1999;61:16-20.
45. Viard I, Wehrli P, Bullani R, et al. Inhibition of toxic epidermal necrolysis by blockade of CD95 with human intravenous immunoglobulin. Science 1998;282:490-3.
46. Campione E, Marulli GC, Carrozzo AM, et al. High dose intravenous immunoglobulin for severe drug reactions: efficacy in toxic epidermal necrolysis. Acta Derm Venereol 2003; 83:430-2.
47. Prins C, Kerdel FA, Padilla RS, et al. Treatment of toxic epidermal necrolysis with high dose intravenous immunoglobulins: multicenter retrospective analysis of 48 consecutive cases. Arch Dermatol 2003;139:26-32.
48. Gottstein R, Cooke RW. Systematic review of intravenous immunoglobulin in haemolytic disease of the newborn. Arch Dis Child Fetal Neonatal Ed 2003;88:F6-10.
49. Alcock GS, Liley H. Immunoglobulin infusion for isoimmune haemolytic jaundice in neonates. Cochrane Database Syst Rev 2002; (3):CD003313.
50. Kiefel V, Bassler D, Kroll H, et al. Antigenpositive platelet transfusion in neonatal alloimmune thrombocytopenia (NAIT). Blood 2006;107:3761-3.
51. Kaplan C. Neonatal alloimmune thrombocytopenia. Haematologica 2008;93:805-7.
52. Martinez V, Cohen P, Pagnoux C, et al.; French Vasculitis Study Group. Intravenous immu-noglobulins for relapses of systemic vasculitides associated with antineutrophil cytoplasmic autoantibodies: results of a multicenter, prospective, open-label study of twentytwo patients. Arthritis Rheum 2008;58:308-17.
53. Jayne DR, Lockwood CM. Intravenous immunoglobulin as sole therapy for systemic vascu- litis. Br J Rheumatol 1996;35:1150-3.
54. Richter C, Schnabel A, Csernok E, De Groot K, Reinhold-Keller E, Gross WL. Treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated systemic vasculitis with high-dose intravenous immunoglobulin. Clin Exp Immunol 1995;101:2-7.
55. Hughes R, Bensa S, Willison H, et al. Randomized controlled trial of intravenous immuno- globulin versus oral prednisolone in chronic inflammatory demyelinating polyradiculoneu- ropathy. Ann Neurol 2001;50:195-201.
56. Hughes RA, Donofrio P, Bril V, et al. Intravenous immune globulin (10% caprylate-chromatography purified) for the treatment of chronic inflammatory demyelinating polyra-diculoneuropathy (ICE study): a randomised placebo-controlled trial. Lancet Neurol 2008;7: 136-44.
57. Robinson J. Hartling L. Vandermeer B, Crumley E, Klassen TP. Intravenous immunoglobulin for presumed viral myocarditis in children and adults. Cochrane Database Syst Rev 2005;25:CD004370.
58. Hamrock DJ. Adverse events associated with intravenous immunoglobulin therapy. Int Im-munopharmacol 2006;4:535-42.
59. Sekul EA, Cupler EJ, Dalakas MC. Aseptic meningitis associated with high-dose intravenous immunoglobulin therapy: frequency and risk factors. Ann Intern Med 1994;121:259-62.
60. Kato E, Shindo S, Eto Y, Hashimoto N, Yamamoto M, Sakata Y, Hiyoshi Y. Administration of immune globulin associated with aseptic meningitis. JAMA 1988;259:3269-71.
61. Casteels-Van Daele M, Wijndaele L, Hanninck K, Gillis P. Intravenous immune globulin and acute aseptic meningitis. N Engl J Med 1990;323:614-5.
62. Kattamis AC, Shankar S, Cohen AR. Neurologic complications of treatment of childhood acute immune thrombocytopenic purpura with intravenously administered immunoglobulin G. J Pediatr 1997;130:281-3.
63. Rao SP, Teitlebaum J, Miller ST. Intravenous immune globulin and aseptic meningitis. Am J Dis Child 1992;146:539-40.
64. Burks AW, Sampson HA, Buckley RH. Anaphylactic reactions after gamma globulin ad-ministration in patients with hypogammaglobulinemia. Detection of IgE antibodies to IgA. N Engl J Med 1986;314:560-4.
65. McCluskey DR, Boyd NA Anaphylaxis with intravenous gammaglobulin. Lancet 1990;336:874.
66. Bachmann R. Studies on the serum gamma- A-globulin level. 3. The frequency of Agamma- A-globulinemia. Scand J Clin Lab Invest 1965;17:316-20.
67. Hammarström L, Persson MA, Smith CI. Anti-IgA in selective IgA deficiency. In vitro effects and Ig subclass pattern of human anti- IgA. Scand J Immunol 1983;18:509-13.
68. Caress JB, Cartwright MS, Donofrio PD, Peacock JE Jr. The clinical features of 16 cases of stroke associated with administration of IVIg. Neurology 2003;60:1822-4.
Corrispondenza: rabusin@burlo.trieste.it