Immune Globulin

[Sue-G]

Posted By  CCF CARDIO MD sc on November 13, 1997 at 12:18:50:

In Reply to: Immune Globulin posted by Sue G. on October 26, 1997 at 19:33:05:

: Do you have any info re: the use of Immune Globulin in the treatment
  of dialated cardiomyopathy?  Is this used for other medical
  conditions?

[CCF Cardio MD sc]

_
Dear Sue G.
Congestive heart failure due to dilated cardiomyopathy affects more than 2 million people in the United States. In about 50% of patients with dilated cardiomyopathy the condition is primary and the cause of the cardiac muscle dysfunction is obscure. Studies in experimental animals and patients with idiopathic  dilated cardiomyopathy suggests that a viral infection may be involved, but that an abnormal response of the body to the infection is what causes the heart muscle dysfunction. It is this supposed auto-immune response to a viral infection that has lead to the use of immune-globulin in the treatment of new onset of dilated cardiomyopathy in an attempt to modulate this immune reaction. The first report  of its use came from the pediatric population and this was followed by a paper published in  “ Circulation”  the official journal of the American Heart Association, where its use in 10 patients at the University of Pittsburgh was reported . In this study 9 of 10 patients had improvement in their heart function and their exercise tolerance. The problem with this study, as the authors themselves explained, was the small number of patients and the lack of double blind randomized nature of this study. As a result a new multi-center trial, called IMAC ( Intervention in Myocardites and Acute Cardiomyopathy with  Intravenous Immunoglobulins ), is currently underway. We are happy here at the Cleveland Clinic to be involved in enrolling patients for this trial. The objective of this study is to determine whether the addition of high-dose intravenous immunoglobulin therapy to standard therapy improves Left Ventricular function and reduces the total mortality and the need for cardiac transplantation. The inclusion criteria for this study are, a Left ventricular ejection fraction less than 40%, recent onset of symptoms ( 6 months from the time of evaluation ).  If you have any questions about this trial here at the  Cleveland Clinic please feel free to call 1-800-CCF-CARE and ask to talk to Karen Kiefer R.N. the study coordinator.
As regards to the second part of your question, immune globulin in used for a variety of other medical conditions. These include immunodeficiency syndromes, idiopathic thrombocytopenic purpura, chronic lymphocitic leukemia, bone marrow transplantation patients, auto-immune hemolytic anemia and neutopenia, refractory dermatomyositis/polymyositis, autoimmune diseases, Kawasaki’s disease and Guillian-Barre syndrome to name a few.
I hope you find this information useful,  if you would like to ask any further questions, or be seen by our heart failure specialists please feel to call 1-800-CCF-CARE to set this up.
Information in this forum is intended for general purposes only, specific diagnosis and treatment can only be determined by your physician.