Intravenous immunoglobulin in autoimmune chronic urticaria
Histamine releasing autoantibodies play a central role in the pathogenesis of chronic urticaria (CU) in approximately 30% of affected patients. We investigated the therapeutic effect of high‐dose intravenous immunoglobulin (IVIG) on disease activity in patients with severe CU of autoimmune aetiology...
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| Veröffentlicht in: | British journal of dermatology (1951) 1998-01, Vol.138 (1), p.101-106 |
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| container_title | British journal of dermatology (1951) |
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| creator | O'DONNELL, B. F BARR, R. M BLACK, A. K FRANCIS, D. M KERMANI, F NIIMI, N BARLOW, R. J WINKELMANN, R. K GREAVES, M. W |
| description | Histamine releasing autoantibodies play a central role in the pathogenesis of chronic urticaria (CU) in approximately 30% of affected patients. We investigated the therapeutic effect of high‐dose intravenous immunoglobulin (IVIG) on disease activity in patients with severe CU of autoimmune aetiology. Autoimmune urticaria was diagnosed by the development of a weal‐and‐flare reaction to the intradermal injection of autologous serum and by serum‐induced histamine release from the basophil leucocytes of healthy donors in vitro. Ten patients with severe, autoimmune CU, poorly responsive to conventional treatment, were treated with IVIG 0.4 g/kg per day for 5 days. The outcome on cutaneous wealing and itch was monitored using urticaria activity scores, visual analogue scales and autologous intradermal serum tests. Clinical benefit was noted in nine of 10 patients; three patients continue in prolonged complete remissions (3 years follow‐up), two had temporary complete remissions, and symptoms in four patients improved subsequent to treatment. There was significant improvement in the urticaria activity scores and visual analogue scores at 2 (P |
| doi_str_mv | 10.1046/j.1365-2133.1998.02033.x |
| format | Article |
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F ; BARR, R. M ; BLACK, A. K ; FRANCIS, D. M ; KERMANI, F ; NIIMI, N ; BARLOW, R. J ; WINKELMANN, R. K ; GREAVES, M. W</creator><creatorcontrib>O'DONNELL, B. F ; BARR, R. M ; BLACK, A. K ; FRANCIS, D. M ; KERMANI, F ; NIIMI, N ; BARLOW, R. J ; WINKELMANN, R. K ; GREAVES, M. W</creatorcontrib><description>Histamine releasing autoantibodies play a central role in the pathogenesis of chronic urticaria (CU) in approximately 30% of affected patients. We investigated the therapeutic effect of high‐dose intravenous immunoglobulin (IVIG) on disease activity in patients with severe CU of autoimmune aetiology. Autoimmune urticaria was diagnosed by the development of a weal‐and‐flare reaction to the intradermal injection of autologous serum and by serum‐induced histamine release from the basophil leucocytes of healthy donors in vitro. Ten patients with severe, autoimmune CU, poorly responsive to conventional treatment, were treated with IVIG 0.4 g/kg per day for 5 days. The outcome on cutaneous wealing and itch was monitored using urticaria activity scores, visual analogue scales and autologous intradermal serum tests. Clinical benefit was noted in nine of 10 patients; three patients continue in prolonged complete remissions (3 years follow‐up), two had temporary complete remissions, and symptoms in four patients improved subsequent to treatment. There was significant improvement in the urticaria activity scores and visual analogue scores at 2 (P < 0.01) and 6 weeks (P < 0.01) post‐IVIG compared with the baseline values (Wilcoxon matched pairs). The diminution in urticarial activity in the majority of patients corresponded with a reduced weal‐and‐flare response to the intradermal injection of autologous post‐treatment serum compared with the pretreatment serum. Minor side‐effects were common, but there were no serious or long‐term adverse effects. IVIG represents a novel therapeutic option in selected patients with recalcitrant CU associated with histamine releasing autoantibodies.</description><identifier>ISSN: 0007-0963</identifier><identifier>EISSN: 1365-2133</identifier><identifier>DOI: 10.1046/j.1365-2133.1998.02033.x</identifier><identifier>PMID: 9536230</identifier><identifier>CODEN: BJDEAZ</identifier><language>eng</language><publisher>Oxford BSL: Blackwell Science Ltd</publisher><subject>Adult ; Aged ; Autoimmune Diseases - blood ; Autoimmune Diseases - therapy ; Biological and medical sciences ; Chronic Disease ; Female ; Follow-Up Studies ; Humans ; Immunoglobulins, Intravenous - adverse effects ; Immunoglobulins, Intravenous - therapeutic use ; Intradermal Tests ; Male ; Medical sciences ; Middle Aged ; Pharmacology. Drug treatments ; Severity of Illness Index ; Skin, nail, hair, dermoskeleton ; Treatment Outcome ; Urticaria - blood ; Urticaria - therapy</subject><ispartof>British journal of dermatology (1951), 1998-01, Vol.138 (1), p.101-106</ispartof><rights>British Association of Dermatology</rights><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4313-c0bf20d37f39060581921cd6fa6f7f72d715aa61eea7ed4baefef1ba9916a2ab3</citedby><cites>FETCH-LOGICAL-c4313-c0bf20d37f39060581921cd6fa6f7f72d715aa61eea7ed4baefef1ba9916a2ab3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1046%2Fj.1365-2133.1998.02033.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1046%2Fj.1365-2133.1998.02033.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,4010,27900,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2133587$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9536230$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>O'DONNELL, B. F</creatorcontrib><creatorcontrib>BARR, R. M</creatorcontrib><creatorcontrib>BLACK, A. K</creatorcontrib><creatorcontrib>FRANCIS, D. M</creatorcontrib><creatorcontrib>KERMANI, F</creatorcontrib><creatorcontrib>NIIMI, N</creatorcontrib><creatorcontrib>BARLOW, R. J</creatorcontrib><creatorcontrib>WINKELMANN, R. K</creatorcontrib><creatorcontrib>GREAVES, M. W</creatorcontrib><title>Intravenous immunoglobulin in autoimmune chronic urticaria</title><title>British journal of dermatology (1951)</title><addtitle>British Journal of Dermatology</addtitle><description>Histamine releasing autoantibodies play a central role in the pathogenesis of chronic urticaria (CU) in approximately 30% of affected patients. We investigated the therapeutic effect of high‐dose intravenous immunoglobulin (IVIG) on disease activity in patients with severe CU of autoimmune aetiology. Autoimmune urticaria was diagnosed by the development of a weal‐and‐flare reaction to the intradermal injection of autologous serum and by serum‐induced histamine release from the basophil leucocytes of healthy donors in vitro. Ten patients with severe, autoimmune CU, poorly responsive to conventional treatment, were treated with IVIG 0.4 g/kg per day for 5 days. The outcome on cutaneous wealing and itch was monitored using urticaria activity scores, visual analogue scales and autologous intradermal serum tests. Clinical benefit was noted in nine of 10 patients; three patients continue in prolonged complete remissions (3 years follow‐up), two had temporary complete remissions, and symptoms in four patients improved subsequent to treatment. There was significant improvement in the urticaria activity scores and visual analogue scores at 2 (P < 0.01) and 6 weeks (P < 0.01) post‐IVIG compared with the baseline values (Wilcoxon matched pairs). The diminution in urticarial activity in the majority of patients corresponded with a reduced weal‐and‐flare response to the intradermal injection of autologous post‐treatment serum compared with the pretreatment serum. Minor side‐effects were common, but there were no serious or long‐term adverse effects. IVIG represents a novel therapeutic option in selected patients with recalcitrant CU associated with histamine releasing autoantibodies.</description><subject>Adult</subject><subject>Aged</subject><subject>Autoimmune Diseases - blood</subject><subject>Autoimmune Diseases - therapy</subject><subject>Biological and medical sciences</subject><subject>Chronic Disease</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Immunoglobulins, Intravenous - adverse effects</subject><subject>Immunoglobulins, Intravenous - therapeutic use</subject><subject>Intradermal Tests</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pharmacology. Drug treatments</subject><subject>Severity of Illness Index</subject><subject>Skin, nail, hair, dermoskeleton</subject><subject>Treatment Outcome</subject><subject>Urticaria - blood</subject><subject>Urticaria - therapy</subject><issn>0007-0963</issn><issn>1365-2133</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkFtP2zAUx62JiXVsHwEpD4i3lOO4seNJPHDZoAMxIW3Am3Xi2JtLLsxOoP32OLTqM5IlH_l_OdaPkITClMKMHy2mlPE8zShjUyplMYUM4rj8QCZbYYdMAECkIDn7RD6HsACgDHLYJbsyZzxjMCHf5m3v8dm03RAS1zRD2_2tu3KoXZvEg0Pfvb2aRP_zXet0MvjeafQOv5CPFutgvm7uPfLnx_ffZ5fp9a-L-dnJdapnjLJUQ2kzqJiwTAKHvKAyo7riFrkVVmSVoDkip8agMNWsRGONpSVKSTlmWLI9crjuffLd_8GEXjUuaFPX2Jr4ayWkKGhsjsZibdS-C8Ebq568a9CvFAU1YlMLNdJRIx01YlNv2NQyRvc3O4ayMdU2uOEU9YONjkFjbT222oWtbSzMCxFtx2vbi6vN6t3r1enP83GK-XSdd6E3y20e_aPigolc3d9cqPMreXtbPNzFslcZmphR</recordid><startdate>199801</startdate><enddate>199801</enddate><creator>O'DONNELL, B. 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Drug treatments</topic><topic>Severity of Illness Index</topic><topic>Skin, nail, hair, dermoskeleton</topic><topic>Treatment Outcome</topic><topic>Urticaria - blood</topic><topic>Urticaria - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>O'DONNELL, B. F</creatorcontrib><creatorcontrib>BARR, R. M</creatorcontrib><creatorcontrib>BLACK, A. K</creatorcontrib><creatorcontrib>FRANCIS, D. M</creatorcontrib><creatorcontrib>KERMANI, F</creatorcontrib><creatorcontrib>NIIMI, N</creatorcontrib><creatorcontrib>BARLOW, R. J</creatorcontrib><creatorcontrib>WINKELMANN, R. K</creatorcontrib><creatorcontrib>GREAVES, M. 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W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intravenous immunoglobulin in autoimmune chronic urticaria</atitle><jtitle>British journal of dermatology (1951)</jtitle><addtitle>British Journal of Dermatology</addtitle><date>1998-01</date><risdate>1998</risdate><volume>138</volume><issue>1</issue><spage>101</spage><epage>106</epage><pages>101-106</pages><issn>0007-0963</issn><eissn>1365-2133</eissn><coden>BJDEAZ</coden><abstract>Histamine releasing autoantibodies play a central role in the pathogenesis of chronic urticaria (CU) in approximately 30% of affected patients. We investigated the therapeutic effect of high‐dose intravenous immunoglobulin (IVIG) on disease activity in patients with severe CU of autoimmune aetiology. Autoimmune urticaria was diagnosed by the development of a weal‐and‐flare reaction to the intradermal injection of autologous serum and by serum‐induced histamine release from the basophil leucocytes of healthy donors in vitro. Ten patients with severe, autoimmune CU, poorly responsive to conventional treatment, were treated with IVIG 0.4 g/kg per day for 5 days. The outcome on cutaneous wealing and itch was monitored using urticaria activity scores, visual analogue scales and autologous intradermal serum tests. Clinical benefit was noted in nine of 10 patients; three patients continue in prolonged complete remissions (3 years follow‐up), two had temporary complete remissions, and symptoms in four patients improved subsequent to treatment. There was significant improvement in the urticaria activity scores and visual analogue scores at 2 (P < 0.01) and 6 weeks (P < 0.01) post‐IVIG compared with the baseline values (Wilcoxon matched pairs). The diminution in urticarial activity in the majority of patients corresponded with a reduced weal‐and‐flare response to the intradermal injection of autologous post‐treatment serum compared with the pretreatment serum. Minor side‐effects were common, but there were no serious or long‐term adverse effects. IVIG represents a novel therapeutic option in selected patients with recalcitrant CU associated with histamine releasing autoantibodies.</abstract><cop>Oxford BSL</cop><pub>Blackwell Science Ltd</pub><pmid>9536230</pmid><doi>10.1046/j.1365-2133.1998.02033.x</doi><tpages>6</tpages></addata></record> |
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| ispartof | British journal of dermatology (1951), 1998-01, Vol.138 (1), p.101-106 |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Aged Autoimmune Diseases - blood Autoimmune Diseases - therapy Biological and medical sciences Chronic Disease Female Follow-Up Studies Humans Immunoglobulins, Intravenous - adverse effects Immunoglobulins, Intravenous - therapeutic use Intradermal Tests Male Medical sciences Middle Aged Pharmacology. Drug treatments Severity of Illness Index Skin, nail, hair, dermoskeleton Treatment Outcome Urticaria - blood Urticaria - therapy |
| title | Intravenous immunoglobulin in autoimmune chronic urticaria |
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