scholarly journals Refractory Toxic Shock-Like Syndrome fromStreptococcus dysgalactiaessp.equisimilisand Intravenous Immunoglobulin as Salvage Therapy: A Case Series

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Marjan Islam ◽  
Dennis Karter ◽  
Jerry Altshuler ◽  
Diana Altshuler ◽  
David Schwartz ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Intravenous Immunoglobulin ◽  
Salvage Therapy ◽  
Adjunctive Therapy ◽  
Case Series ◽  
Ivig Therapy ◽  
Mortality Rates ◽  
Invasive Disease ◽  
Streptococcus Dysgalactiae ◽  
Toxic Shock

Infections fromStreptococcus dysgalactiaessp.equisimilis(SDSE) can cause a wide variety of infections, ranging from mild cellulitis to invasive disease, such as endocarditis and streptococcal toxic shock-like syndrome (TSLS). Despite prompt and appropriate antibiotics, mortality rates associated with shock have remained exceedingly high, prompting the need for adjunctive therapy. IVIG has been proposed as a possible adjunct, given its ability to neutralize a wide variety of superantigens and modulate a dysregulated inflammatory response. We present the first reported cases of successful IVIG therapy for reversing shock in the treatment of SDSE TSLS.

Canadian Consensus Statement on the Use of Intravenous Immunoglobulin Therapy in Dermatology

2006 ◽  
Vol 10 (5) ◽  
pp. 205-221 ◽  
Author(s):  
P. Régine Mydlarski ◽  
Vincent Ho ◽  
Neil H. Shear
Keyword(s):  
Intravenous Immunoglobulin ◽  
Skin Disease ◽  
Consensus Statement ◽  
Case Series ◽  
Ivig Therapy ◽  
Stevens Johnson Syndrome ◽  
Mucous Membrane Pemphigoid ◽  
Pemphigus Foliaceus ◽  
Intravenous Immunoglobulin Therapy ◽  
Therapeutic Algorithms

Background: As a safe, well-tolerated, and potentially beneficial therapy, intravenous immunoglobulin (IVIG) has been increasingly used by dermatologists to treat immune-mediated skin disease. However, practical and comprehensive guidelines for the use of IVIG have yet to be established. Objective: To develop the first Canadian consensus statement on the use of IVIG therapy in skin disease. Methods: A group of Canadian dermatologists convened to discuss current issues in IVIG therapy. The participants reviewed and evaluated the literature and shared clinical experience. Using a modified Delphi process, a consensus statement was developed. Results: Herein we provide a brief overview of pemphigus vulgaris, pemphigus foliaceus, bullous pemphigoid, mucous membrane pemphigoid, epidermolysis bullosa acquisita, Stevens-Johnson syndrome, and toxic epidermal necrolysis. Recommendations for the management of these diseases are detailed, and therapeutic algorithms for the treatment of various autoimmune mucocutaneous blistering diseases are presented. The appropriate use of IVIG therapy is placed in context for each disease. Conclusion: Although preliminary data suggest that IVIG is a safe and effective therapy for many skin disorders, uncontrolled clinical trials, case series, and anecdotal case reports dominate the literature. Collaborative randomized controlled trials are required to firmly establish the role of IVIG in dermatology.

scholarly journals Refractory Toxic Shock-Like Syndrome From Group C Streptococcus Dysgalactiae Ssp. Equismilis Endocarditis and IVIG as Salvage Therapy

CHEST Journal ◽  
2016 ◽  
Vol 150 (4) ◽  
pp. 397A
Author(s):  
Marjan Islam ◽  
Jerry Altshuler ◽  
Gianluca Torregrossa ◽  
Dennis Karter
Keyword(s):  
Salvage Therapy ◽  
Streptococcus Dysgalactiae ◽  
Toxic Shock

scholarly journals Intravenous immunoglobulin therapy in COVID-19-related encephalopathy

2020 ◽  
Author(s):  
Lorenzo Muccioli ◽  
Umberto Pensato ◽  
Giorgia Bernabè ◽  
Lorenzo Ferri ◽  
Maria Tappatà ◽  
...  
Keyword(s):  
Intravenous Immunoglobulin ◽  
Neuropsychiatric Symptoms ◽  
Brain Mri ◽  
Invasive Mechanical Ventilation ◽  
Case Series ◽  
Ivig Therapy ◽  
Immunoglobulin Therapy ◽  
Severe Respiratory Distress ◽  
Intravenous Immunoglobulin Therapy ◽  
Extrapyramidal Signs

Abstract Objective To report on efficacy and safety of intravenous immunoglobulin (IVIg) therapy in a case series of patients with COVID-19-related encephalopathy. Methods We retrospectively collected data on all patients with COVID-19 hospitalized at two Italian hospitals who developed encephalopathy during disease course and were treated with IVIg. Results Five patients (two females, mean age 66.8 years) developed encephalopathy after a mean of 12.6 days, since the onset of respiratory/constitutional symptoms related to COVID-19. Four patients suffered severe respiratory distress, three of which required invasive mechanical ventilation. Neurological manifestations included impaired consciousness, agitation, delirium, pyramidal and extrapyramidal signs. EEG demonstrated diffuse slowing in all patients. Brain MRI showed non-specific findings. CSF analysis revealed normal cell count and protein levels. In all subjects, RT-PCR for SARS-CoV-2 in CSF tested negative. IVIg at 0.4 g/kg/die was commenced 29.8 days (mean, range: 19–55 days) after encephalopathy onset, leading to complete electroclinical recovery in all patients, with an initial improvement of neuropsychiatric symptoms observed in 3.4 days (mean, range: 1–10 days). No adverse events related to IVIg were observed. Conclusions Our preliminary findings suggest that IVIg may represent a safe and effective treatment for COVID-19-associated encephalopathy. Clinical efficacy may be driven by the anti-inflammatory action of IVIg, associated with its anti-cytokine qualities.

Toxic shock syndrome in Australian children

2016 ◽  
Vol 101 (8) ◽  
pp. 736-740 ◽  
Author(s):  
Katherine Y H Chen ◽  
Michael Cheung ◽  
David P Burgner ◽  
Nigel Curtis
Keyword(s):  
Intensive Care ◽  
Intravenous Immunoglobulin ◽  
Adjunctive Therapy ◽  
Toxic Shock Syndrome ◽  
Early Recognition ◽  
Retrospective Chart Review ◽  
Fresh Frozen Plasma ◽  
Case Definition ◽  
Toxic Shock ◽  
Fresh Frozen

BackgroundThere are limited data describing the epidemiology, management and outcomes of children with toxic shock syndrome (TSS), a potentially life-threatening illness. Here, we describe the incidence, clinical features, treatment and outcome of children with staphylococcal and streptococcal TSS in Victoria, Australia.MethodsRetrospective chart review of children admitted between 2003 and 2014 to two tertiary paediatric referral centres who fulfilled the Centers for Disease Control and Prevention case definition of TSS.ResultsThere were 62 cases over the 11-year period; 43 staphylococcal TSS and 19 streptococcal TSS. The majority (46 (74%)) of cases were admitted to an intensive care unit and 44 (71%) required inotropic support. Compared with those with staphylococcal TSS, patients with streptococcal TSS were younger, more unwell and more likely to have residual morbidity. Adjunctive therapy with intravenous immunoglobulin or clindamycin was used in 58 (94%) of cases and fresh frozen plasma was used in 15 (24%). Seven patients received extracorporeal membrane oxygenation. All patients survived.ConclusionsThis study highlights the importance of early recognition of TSS and supports rapid tertiary referral and intensive care management, which includes the use of adjunctive therapy with intravenous immunoglobulin and clindamycin.

scholarly journals Streptococcus Dysgalactiae Cellulitis and Toxic Shock-Like Syndrome in a Brown Swiss Cow

2008 ◽  
Vol 20 (1) ◽  
pp. 99-103 ◽  
Author(s):  
Sonia Chénier ◽  
Mathilde Leclère ◽  
Serge Messier ◽  
Gilles Fecteau
Keyword(s):  
Streptococcus Dysgalactiae ◽  
Toxic Shock ◽  
Brown Swiss

scholarly journals VNTR2/VNTR3 genotype in the FCGRT gene is associated with reduced effectiveness of intravenous immunoglobulin in patients with myasthenia gravis

2021 ◽  
Vol 14 ◽  
pp. 175628642098674
Author(s):  
Shengyao Su ◽  
Qing Liu ◽  
Xueping Zhang ◽  
Xinmei Wen ◽  
Lin Lei ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Intravenous Immunoglobulin ◽  
Medical Records ◽  
Daily Living ◽  
Response Rate ◽  
Predictive Marker ◽  
Ivig Therapy ◽  
Variable Number ◽  
Ivig Treatment ◽  
Therapeutic Outcomes

Background: Intravenous immunoglobulin (IVIG) has been commonly used to treat myasthenia gravis exacerbation, but is still ineffective in nearly 30% of patients. A variable number of tandem repeat (VNTR) polymorphism in the FCGRT gene has been found to reduce the efficiency of IgG biologics. However, whether the polymorphism influences the efficacy of IVIG in generalized myasthenia gravis (MG) patients with exacerbations remains unknown. Methods: The distribution of VNTR genotypes was analyzed in 334 patients with MG. Varied VNTR alleles were determined by capillary electrophoresis and confirmed by Sanger sequencing. Information of endogenous IgG levels were collected in patients without previous immunotherapy ( n = 26). Medical records of patients who received IVIG therapy were retrospectively analyzed for therapeutic outcomes of IVIG treatment ( n = 61). Patients whose Activities of Daily Living scores decreased by 2 or more points on day 14 were considered responders to the treatment. Results: The VNTR3/3 and VNTR2/3 genotypes were detected in 96.7% (323/334) and 3.4% (11/334) patients, respectively. Patients with VNTR2/3 heterozygosity had lower endogenous IgG levels than those with VNTR3/3 homozygosity (9.81 ± 2.61 g/L versus 12.41 ± 2.45g/L, p = 0.016). The response rate of IVIG therapy was 78.7% (48/61). All responders and nine non-responders were VNTR3/3 homozygotes, whereas all the patients with VNTR2/3 genotypes were non-responders ( n = 4). In patients who took IVIG treatments, endogenous IgG levels were significantly lower in non-responders compared with responders (12.93 ± 2.24 g/L versus 8.85 ± 2.69 g/L, p = 0.006), especially in VNTR2/3 heterozygotes (7.86 ± 1.78 g/L, p = 0.001). Conclusion: The VNTR2/3 genotype could influence endogenous IgG levels and serve as a predictive marker for poor responses to IVIG in MG patients.

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