New uses for intravenous immune globulin
Article Abstract:
Three separate articles in the July 11, 1991 issue of The New England Journal of Medicine discuss the medical use of intravenous immune globulin. This may seem surprising in light of the fact that the Physician's Desk Reference only lists two rare disorders for which this treatment is indicated. Clinicians are becoming interested in immune globulins in the treatment of patients with compromised immune systems, since the treatment is safe and rapidly effective in the prevention of infection with common bacteria. Immune globulins are antibodies purified from the pooled blood of thousands of donors. For patients lacking the ability to manufacture sufficient quantities of their own protective antibodies, the injection of the immune globulins brings the amount of antibodies in their blood up to protective levels virtually instantaneously. Since the protection is passive (not produced by the patient, but given to him), however, the benefit lasts only as long as the donor antibodies persist, which appears to be about a month. The immune globulins are costly to produce, and the necessity of regular treatment makes the treatment method enormously expensive. Recent research has shown that immune globulins are effective in reducing bacterial infections in children with AIDS. Studies have also shown that death due to pneumonia in premature babies resulting from infection with cytomegalovirus may be reduced by the use of intravenous immune globulins. Immune globulins may also find a place in the treatment of immunoregulatory disorders, that is, diseases which result when the normally balanced immune system goes awry. Such immunoregulatory disorders for which intravenous immune globulins may prove useful include polymyositis, Guillain-Barre syndrome, myasthenia gravis, and steroid-dependent asthma. The high cost of intravenous immune globulin may make its use most appropriate for short-term treatment, and the cost effectiveness must be carefully considered if it is to be used for long-term therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1991
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Rapid serologic testing with immune-complex-dissociated HIV p24 antigen for early detection of HIV infection in neonates
Article Abstract:
Use of an assay that dissociates antibody-antigen complexes may assist in the early diagnosis of HIV infection in infants born to infected mothers. Standard HIV testing detects antibodies to HIV antigens, but passive transfer of antibodies from mother to fetus may interfere with HIV testing results in newborn infants. Blood samples from 78 children were tested for the presence of antibody-dissociated p24 antigen, which is specific to the HIV virus. Using this procedure, p24 antigen was detected in nine of 14 children with asymptomatic HIV infection and in 25 of 28 children with symptomatic HIV infection. Furthermore, test results were negative in all 19 infants born to HIV-negative mothers and in all 12 HIV-negative infants born to HIV-positive mothers. Detection of p24 antigen following antibody-antigen dissociation is a fast and simple procedure that could be readily incorporated into routine laboratory testing procedures.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1993
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Prophylactic intravenous administration of standard immune globulin as compared with core-lipopolysaccharide immune globulin in patients at high risk of postsurgical infection
Article Abstract:
Intravenous immune globulin, or antibody, may be more effective than core-lipopolysaccharide hyperimmune globulin in reducing the risk of a nosocomial infection in patients after surgery. Nosocomial infections are hospital-acquired infections. Of 329 hospital intensive care unit (ICU) patients, 109 were treated with intravenous immune globulin, 108 were treated with intravenous core-lipopolysaccharide immune globulin and 112 received a placebo, an inactive substance. Thirty-six patients (33%) treated with immune globulin developed a nosocomial infection, compared with 50 (46%) treated with core-lipopolysaccharide immune globulin and 53 (47%) who received a placebo. Patients treated with immune globulin spent less average time in the ICU and the hospital, compared with those treated with core-lipopolysaccharide immune globulin or placebo.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1992
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