Intravenous immune globulin treatment of pulmonary exacerbations in cystic fibrosis

The effect of intravenously administered immune globulin (IVIG) on patients with cystic fibrosis with an acute exacerbation of pulmonary infection was evaluated in a double-blind study. Patients at least 12 years of age, with chronic respiratory tract colonization with Pseudomonas aeruginosa and hos...

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Veröffentlicht in:The Journal of pediatrics 1989-02, Vol.114 (2), p.309-314
Hauptverfasser: Winnie, Glenna B., Cowan, Robert G., Wade, Nancy A.
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container_title The Journal of pediatrics
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creator Winnie, Glenna B.
Cowan, Robert G.
Wade, Nancy A.
description The effect of intravenously administered immune globulin (IVIG) on patients with cystic fibrosis with an acute exacerbation of pulmonary infection was evaluated in a double-blind study. Patients at least 12 years of age, with chronic respiratory tract colonization with Pseudomonas aeruginosa and hospitalized with a reduction in pulmonary function, were randomly assigned to receive 20% dextrose (control subjects: n=9) or 100 mg/kg IVIG (Gamimune) (experimental subjects: n=8) on days 1, 2, and 3; all patients received intravenous antibiotics and chest physiotherapy. There were no differences between groups on admission; patients had moderate to severe disease as measured by Shwachman-Kulczycki scores and pulmonary function tests. Both groups improved clinically. The IVIG treatment was associated with significant increases in forced vital capacity and forced expiratory volume in 1 second ( p
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Patients at least 12 years of age, with chronic respiratory tract colonization with Pseudomonas aeruginosa and hospitalized with a reduction in pulmonary function, were randomly assigned to receive 20% dextrose (control subjects: n=9) or 100 mg/kg IVIG (Gamimune) (experimental subjects: n=8) on days 1, 2, and 3; all patients received intravenous antibiotics and chest physiotherapy. There were no differences between groups on admission; patients had moderate to severe disease as measured by Shwachman-Kulczycki scores and pulmonary function tests. Both groups improved clinically. The IVIG treatment was associated with significant increases in forced vital capacity and forced expiratory volume in 1 second ( p&lt;0.01) and with greater percent improvement in forced expiratory volume and forced expiratory flow (25% to 75%) ( p&lt;0.05). There was no effect on length of hospitalization (18.3±11.9 days control vs 17.6±6.5 experimental). The C3 level was decreased at discharge In IVIG-treated patients; circulating immune complex levels were unchanged. One patient in each group experienced side effects. There were no differences on follow-up at 6 weeks. We conclude that IVIG infusion early in treatment for pulmonary exacerbations in cystic fibrosis patients with moderate to severe disease may be associated with greater improvement in pulmonary function than standard treatment alone.</description><identifier>ISSN: 0022-3476</identifier><identifier>EISSN: 1097-6833</identifier><identifier>DOI: 10.1016/S0022-3476(89)80804-2</identifier><identifier>PMID: 2915293</identifier><identifier>CODEN: JOPDAB</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Biological and medical sciences ; Cystic Fibrosis - complications ; Cystic Fibrosis - immunology ; Cystic Fibrosis - physiopathology ; Double-Blind Method ; Forced Expiratory Volume ; Gastroenterology. Liver. Pancreas. 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Patients at least 12 years of age, with chronic respiratory tract colonization with Pseudomonas aeruginosa and hospitalized with a reduction in pulmonary function, were randomly assigned to receive 20% dextrose (control subjects: n=9) or 100 mg/kg IVIG (Gamimune) (experimental subjects: n=8) on days 1, 2, and 3; all patients received intravenous antibiotics and chest physiotherapy. There were no differences between groups on admission; patients had moderate to severe disease as measured by Shwachman-Kulczycki scores and pulmonary function tests. Both groups improved clinically. The IVIG treatment was associated with significant increases in forced vital capacity and forced expiratory volume in 1 second ( p&lt;0.01) and with greater percent improvement in forced expiratory volume and forced expiratory flow (25% to 75%) ( p&lt;0.05). There was no effect on length of hospitalization (18.3±11.9 days control vs 17.6±6.5 experimental). The C3 level was decreased at discharge In IVIG-treated patients; circulating immune complex levels were unchanged. One patient in each group experienced side effects. There were no differences on follow-up at 6 weeks. We conclude that IVIG infusion early in treatment for pulmonary exacerbations in cystic fibrosis patients with moderate to severe disease may be associated with greater improvement in pulmonary function than standard treatment alone.</description><subject>Biological and medical sciences</subject><subject>Cystic Fibrosis - complications</subject><subject>Cystic Fibrosis - immunology</subject><subject>Cystic Fibrosis - physiopathology</subject><subject>Double-Blind Method</subject><subject>Forced Expiratory Volume</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Immunization, Passive</subject><subject>Immunoglobulin G - analysis</subject><subject>Immunoglobulins - administration &amp; dosage</subject><subject>Injections, Intravenous</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Medical sciences</subject><subject>Other diseases. 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Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Immunization, Passive</topic><topic>Immunoglobulin G - analysis</topic><topic>Immunoglobulins - administration &amp; dosage</topic><topic>Injections, Intravenous</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Medical sciences</topic><topic>Other diseases. Semiology</topic><topic>Pseudomonas Infections - immunology</topic><topic>Pseudomonas Infections - physiopathology</topic><topic>Pseudomonas Infections - therapy</topic><topic>Random Allocation</topic><topic>Vital Capacity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Winnie, Glenna B.</creatorcontrib><creatorcontrib>Cowan, Robert G.</creatorcontrib><creatorcontrib>Wade, Nancy A.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Winnie, Glenna B.</au><au>Cowan, Robert G.</au><au>Wade, Nancy A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intravenous immune globulin treatment of pulmonary exacerbations in cystic fibrosis</atitle><jtitle>The Journal of pediatrics</jtitle><addtitle>J Pediatr</addtitle><date>1989-02-01</date><risdate>1989</risdate><volume>114</volume><issue>2</issue><spage>309</spage><epage>314</epage><pages>309-314</pages><issn>0022-3476</issn><eissn>1097-6833</eissn><coden>JOPDAB</coden><abstract>The effect of intravenously administered immune globulin (IVIG) on patients with cystic fibrosis with an acute exacerbation of pulmonary infection was evaluated in a double-blind study. Patients at least 12 years of age, with chronic respiratory tract colonization with Pseudomonas aeruginosa and hospitalized with a reduction in pulmonary function, were randomly assigned to receive 20% dextrose (control subjects: n=9) or 100 mg/kg IVIG (Gamimune) (experimental subjects: n=8) on days 1, 2, and 3; all patients received intravenous antibiotics and chest physiotherapy. There were no differences between groups on admission; patients had moderate to severe disease as measured by Shwachman-Kulczycki scores and pulmonary function tests. Both groups improved clinically. The IVIG treatment was associated with significant increases in forced vital capacity and forced expiratory volume in 1 second ( p&lt;0.01) and with greater percent improvement in forced expiratory volume and forced expiratory flow (25% to 75%) ( p&lt;0.05). There was no effect on length of hospitalization (18.3±11.9 days control vs 17.6±6.5 experimental). The C3 level was decreased at discharge In IVIG-treated patients; circulating immune complex levels were unchanged. One patient in each group experienced side effects. There were no differences on follow-up at 6 weeks. We conclude that IVIG infusion early in treatment for pulmonary exacerbations in cystic fibrosis patients with moderate to severe disease may be associated with greater improvement in pulmonary function than standard treatment alone.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>2915293</pmid><doi>10.1016/S0022-3476(89)80804-2</doi><tpages>6</tpages></addata></record>
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subjects Biological and medical sciences
Cystic Fibrosis - complications
Cystic Fibrosis - immunology
Cystic Fibrosis - physiopathology
Double-Blind Method
Forced Expiratory Volume
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Immunization, Passive
Immunoglobulin G - analysis
Immunoglobulins - administration & dosage
Injections, Intravenous
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Medical sciences
Other diseases. Semiology
Pseudomonas Infections - immunology
Pseudomonas Infections - physiopathology
Pseudomonas Infections - therapy
Random Allocation
Vital Capacity
title Intravenous immune globulin treatment of pulmonary exacerbations in cystic fibrosis
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