IngentaConnect Treatment of pyoderma gangrenosum with intravenous immunoglobulin

Authors: Cummins, D.L.; Anhalt, G.J.; Monahan, T.¹; Meyerle, J.H.

Source: British Journal of Dermatology, Volume 157, Number 6, December 2007 , pp. 1235-1239(5)

Abstract:

Summary Background

Intravenous immunoglobulin (IVIG) is increasingly being used to treat inflammatory and autoimmune disease. Objectives

To elucidate the efficacy of IVIG as an adjunct treatment for pyoderma gangrenosum (PG). Patients/methods

Ten patients with PG were treated with IVIG at Johns Hopkins Department of Dermatology. All patients had severe mutilating and/or refractory disease requiring multi-agent therapy. The charts were reviewed retrospectively. Results

Seven of the ten patients had clearance of PG lesions in the setting of IVIG and six of these patients maintained efficacy with repeated IVIG treatment. Five patients complained of nausea with treatment, and in one case nausea was severe and intractable. One patient developed an immune reaction requiring diphenhydramine and methylprednisolone and another experienced aseptic meningitis. Conclusions

IVIG may be an effective adjuvant in the treatment of PG and has an acceptable side-effect profile. Randomized, placebo-controlled, double-blinded trials are needed to confirm this hypothesis.

Keywords: intravenous immunoglobulin; IVIG; pyoderma gangrenosum

Document Type: Research article

DOI: 10.1111/j.1365-2133.2007.08217.x

Affiliations: 1: Department of Dermatology, Johns Hopkins Medical Institutions, 601 North Caroline Street, Suite 6042, Baltimore, MD 21287, U.S.A.

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