A controlled trial of intravenous immunoglobulin G in chronic fatigue syndrome
Article Abstract:
Chronic fatigue syndrome is a newly-defined illness that is characterized by various abnormalities of the immune system and symptoms of prolonged and incapacitating fatigue, fever, widespread pain, depression, and problems with sleeping and concentrating. Chronic viral infection or defects in the regulatory function of the immune system have been proposed as possible causes of this syndrome. The effectiveness of immunoglobulin G (IgG), an immune protein, in treating chronic fatigue syndrome was assessed. The blood levels of IgG and various classes of lymphocytes, a type of immune cell, were measured at the beginning of the study. The effect of IgG given intravenously on the levels of various subclasses of IgG were determined. The study involved 30 patients with chronic fatigue syndrome; half were treated with 1 gram per kilogram of immunoglobulin G and half received a placebo. Treatments were administered every 30 days for six months. Patients were surveyed on severity of symptoms, ability to function, and health assessment, and were required to report worsening of symptoms within 48 hours of treatment. All 28 patients who completed the study reported moderate-to-severe fatigue, impaired social function, and poor health at the start of the study. Twelve patients had low levels of IgG1, and 18 patients had low levels of IgG3. Treatment with IgG did not alleviate symptoms or improve functional status, although IgG1 levels were restored to normal. Adverse effects occurred in 20 percent of both the IgG-treated and placebo groups. These findings suggest that IgG given intravenously has no clinical benefit for patients with chronic fatigue syndrome. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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Intravenous immunoglobulin treatment for the chronic fatigue syndrome
Article Abstract:
The chronic fatigue syndrome is characterized by prolonged and incapacitating fatigue, fever, widespread pain, depression, and difficulty sleeping and concentrating. Chronic infection and neurosis have been suggested as possible causes of this syndrome. Studies show that patients with this syndrome often have a deficiency in immunoglobulin, a type of immune protein. Two recent studies that appeared in the November 1990 issue of The American Journal of Medicine examined the effectiveness of immunoglobulin treatments in patients with chronic fatigue syndrome. In the Australian study, symptoms improved in 10 of 23 patients treated with a very high dose of 2 grams (g) per kilogram (kg) of immunoglobulin and in only 3 of 26 patients given a placebo. In the American study, the rate of improvement was similar for patients treated with 1 g per kg immunoglobulin and for patients given a placebo. The differences between the results of the Australian and American studies may be related to the number of participants, the dose of immunoglobulin, criteria for diagnosing chronic fatigue syndrome, and methods used for determining improvement. The use of immunoglobulin for treating chronic fatigue syndrome is not recommended because of high costs, lack of definitive evidence showing efficacy, and adverse side effects. Both studies showed that chronic fatigue syndrome was associated with neuropsychologic and physical impairment and disability, along with deficiencies in immunoglobulin. In addition, patients with this syndrome who improved clinically also had improved immune characteristics. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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A double-blind, placebo-controlled trial of intravenous immunoglobulin therapy in patients with chronic fatigue syndrome
Article Abstract:
Chronic fatigue syndrome is a disorder of unknown origin which is characterized by extreme fatigue, impaired neuropsychiatric function, and abnormalities in cell-mediated immune reactions. There is no known effective treatment for chronic fatigue syndrome. The effectiveness of treatment with a high dose of immunoglobulin G (IgG), an immune protein, which was given intravenously, was assessed in patients with this condition. Subjects received either 2 grams per kilogram of IgG or a placebo. A physician and psychiatrist evaluated the severity of symptoms and associated disability of all the patients before and after treatment. Physical symptoms and functional capacity were assessed by visual tests, whereas psychologic changes were evaluated using self-reports of depression. Indicators of cell-mediated immunity included measurements of subsets of T-cells, a type of immune cell; skin testing for delayed hypersensitivity; and ability of lymphocytes, a type of immune cell, to transform in the presence of the substance phytohemagglutinin. Ten out of 23 patients treated with IgG and 3 of 26 patients given a placebo showed improvement in symptoms and were able to resume work social activities. Patients who responded to treatment with IgG showed improved physical, psychologic, and immune characteristics. These findings suggest that IgG treatment is effective in relieving the symptoms of chronic fatigue syndrome, and that immunological disturbances are involved in this condition. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
User Contributions:
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