Effectiveness of Intravenous Immunoglobulin for Management of Pain in Patients with Postpolio Syndrome.

Min Cheol Chang,Jong-Moon Hwang,Donghwi Park,Jin-Sung Park,Giustino Varrassi

doi:10.1155/2021/6637705

Abstract

Objective Many patients with postpolio syndrome (PPS) experience pain. In this study, we aimed to review previous studies to investigate the effectiveness of intravenous immunoglobulin (IVIG) for managing pain in patients with PPS. We performed a narrative review. Methods In PubMed, we searched for the keywords ((Immunoglobulin OR IVIG) AND (poliomyelitis OR poliomyelitis syndrome)). We included articles in which IVIG was infused in patients with PPS and pain severity was measured before and after treatment. Results In the results, five articles (4 randomized controlled trials and 1 prospective observational study) were included in this review. Four of the studies reported that IVIG had a positive pain-reducing effect in patients with PPS. In addition, 4 studies evaluated the outcomes related to muscle strength and function. Of these studies, 3 showed some improvement in measurements for muscle strength and function. Conclusion In conclusion, IVIG might be one of the beneficial options for managing pain in PPS. Pain reduction might be responsible for the improvement of muscle strength or function. To confirm the benefits of IVIG in reducing pain, more high-quality studies are required.

Highlights

Postpolio syndrome (PPS) was reported in survivors from acute poliomyelitis infection [1]. e prevalence of polio survivors with postpolio syndrome (PPS) ranged from 20% to 80%, depending on the study population and diagnostic criteria [2]
We aimed to review previous studies to investigate the effectiveness of intravenous immunoglobulin (IVIG) for managing pain in patients with PPS
C.) independently performed a literature search in PubMed. Differences in their search results were resolved through a discussion. e keywords used in the search were ((Immunoglobulin OR IVIG) AND). e search was limited to articles published up to June 27, 2020. e following inclusion criteria were applied for the selection of articles: (1) IVIG was infused in patients with PPS, (2) pain severity was measured before and after treatment, and (3) written in English

Summary

Introduction

Postpolio syndrome (PPS) was reported in survivors from acute poliomyelitis infection [1]. e prevalence of polio survivors with PPS ranged from 20% to 80%, depending on the study population and diagnostic criteria [2]. Postpolio syndrome (PPS) was reported in survivors from acute poliomyelitis infection [1]. E prevalence of polio survivors with PPS ranged from 20% to 80%, depending on the study population and diagnostic criteria [2]. E symptoms of PPS include muscle weakness, fatigue, and pain [3, 4]. Ongoing denervation is known to be the most important cause of muscle weakness from PPS [3, 4]. Muscle pain is caused by overuse of weak muscles or other muscles that compensate for the weakened polio-affected muscles [7]. Joint pain is caused by abnormal biomechanics, leg-length discrepancy, and muscle atrophy [7]. Neuropathic pain can develop from neuroinflammation induced by poliomyelitis infection and a concomitant disorder in the nervous system, such as nerve impingement and herniated lumbar disk [7, 10]

Methods

Results

Conclusion