Re: CDIP/Guillium Barre -- IVIG Therapy vs Plasmapheresus
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Posted by CCF Neurology LG on March 01, 1998 at 03:15:16:
In Reply to: CDIP/Guillium Barre -- IVIG Therapy vs Plasmapheresus posted by MLR on February 28, 1998 at 15:28:57:
: My mother has CDIP (among several other auto immune disorders) - We are investigating intervention options. Can you refer us to a source or studies that compare and contrast the benefits of plasmapherisus (SP) vs. IVIG therapy? Also, can you tell us what the effects or contraindications of IVIG therapy are related to the kidneys. My mother only has one kidney. Additionally, my mother has had two boughts with septicimia from a central line -- what are the risk factors and the likelihood of a reoccurance of sepsis when receiving plasmapheresus? We have had a difficult time finding answers to these questions. Thank you for your assistance.
Several trials of IVIG have shown benefit in patients with CIDP. In one study, more that 50% of patients responded to treatment for weeks to months., after which the infusions must be repeated. This therapy tends to be very expensive and takes several hours for a transfusion. Rare instances of NEPHROTIC syndrome, low blood pressure, and meningitis have been reported but in general ther are no ill effects. Approximately 50% of the patients who undergo plasma exchange have reponded to therapy. In one study, plasma exchange administered two times a week for three weeks, had a beneficial effect on both neurologic disability and nerve conduction. However, the beneficial effects began to fade in 10-14 days. The respone to plasma exchange is comparable to that seen with IVIG, some patients responding better to certain treatments. Also there is always a chance of infection/sepsis with any intravenous line. Some references that may be helpful: 1. Plasma Exchange in CIDP, Hahn, Brain 119:p1055, 1996; 2. IVIG treatmetn in CIDP, Hahn, Brain 119:p1067, 1996; 3.Plasma Exchange in CIDP, Dyke, New England Journal of Medicine 314:461, 1986. I hope this helps. Good Luck.
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