Immunoglobulin use in neurology: a practical approach.

IF 2.4 Q2 CLINICAL NEUROLOGY
Mahima Kapoor, Anthony Khoo, Michael P T Lunn, Stephen Reddel, Aisling S Carr
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引用次数: 0

Abstract

Human immunoglobulin, delivered either intravenously (IVIg) or subcutaneously, is used to treat a range of immune-mediated neurological disorders. It has a role in acute or subacute inflammatory disease control and as a maintenance therapy in chronic disease management. This review considers mechanisms of IVIg action and the evidence for IVIg in neurological conditions. We use Guillain-Barré syndrome and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) as frameworks to demonstrate an approach to IVIg use in acute and chronic dysimmune neurological conditions across two different healthcare systems: the UK and Australia. We highlight the benefits and limitations of IVIg and focus on practical considerations such as informed consent, managing risks and adverse effects, optimal dosing and monitoring response. We use these basic clinical practice principles to discuss the judicious use of an expensive and scarce blood product with international relevance.

免疫球蛋白在神经病学中的应用:实用方法。
人免疫球蛋白可静脉注射(IVIg)或皮下注射,用于治疗一系列免疫介导的神经系统疾病。它可用于急性或亚急性炎症性疾病的控制,也可作为慢性疾病治疗的维持疗法。本综述探讨了 IVIg 的作用机制以及 IVIg 治疗神经系统疾病的证据。我们以吉兰-巴雷综合征和慢性炎症性脱髓鞘多发性神经病(CIDP)为框架,展示了英国和澳大利亚两种不同医疗体系在急性和慢性免疫障碍性神经疾病中使用 IVIg 的方法。我们强调了 IVIg 的优点和局限性,并重点介绍了知情同意、管理风险和不良反应、最佳剂量和监测反应等实际注意事项。我们利用这些基本的临床实践原则来讨论如何合理使用昂贵而稀缺的血液制品,这在国际上具有重要意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
PRACTICAL NEUROLOGY
PRACTICAL NEUROLOGY Medicine-Neurology (clinical)
CiteScore
3.70
自引率
3.60%
发文量
113
期刊介绍: The essential point of Practical Neurology is that it is practical in the sense of being useful for everyone who sees neurological patients and who wants to keep up to date, and safe, in managing them. In other words this is a journal for jobbing neurologists - which most of us are for at least part of our time - who plough through the tension headaches and funny turns week in and week out. Primary research literature potentially relevant to routine clinical practice is far too much for any neurologist to read, let alone understand, critically appraise and assimilate. Therefore, if research is to influence clinical practice appropriately and quickly it has to be digested and provided to neurologists in an informative and convenient way.
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