EFFECTS OF INTRAVENOUS IMMUNOGLOBULIN THERAPY ON EXERCISE PERFORMANCE: A CASE STUDY

Abstract

117 Intravenous immunoglobulin (IVIG) has been used either for antibody replacement or as biological response modifiers. Regular IVIG therapy patients who exercise often report feelings of fatigue as they approach the end of an IVIG infusion cycle. The purpose of this case study was to examine the cyclical effects of IVIG therapy on isokinetic muscle performance, as well as submaximal and maximal aerobic performance. We investigated the responses of an active 44-year-old male with polyglandular type II autoimmune disorder and autoimmune retinopathy, who was receiving regular IVIG therapy. Exercise tests were conducted on post-infusion days (PIDs) 1, 8, 15, and 18 for three consecutive 21-day infusion cycles. Procedures for all 12 test days consisted of first performing one set of 10 maximal repetitions of knee flexion and extension at 120 °/s on an isokinetic dynamometer. Differences in mean peak torque, mean work, and mean average power between any two PIDs were 6% or less. Later each PID, a progressive exercise test to volitional fatigue was performed on a cycle ergometer. Mean differences in HRmax between any two PIDs was 6% or less. Differences in mean VO2max on PIDs 1, 8, and 15 were all within 3%. PID 18 was 8-11% less than the other PIDs. At submaximal workloads, the HR, OBLA and VO2 curves were similar for all PIDs. We found no objective evidence of exercise performance variation at any time during the interval between IVIG doses, beyond typical isokinetic and cycle ergometry testing variations reported in studies using healthy subjects.