Evaluating possible use of IVIG in autism spectrum disorder (ASD)

Abstract

Background: Autism spectrum disorder (ASD) is a multifactorial disorder which causes communication, behavioral, as well as developmental impairments, and it significantly impacts the quality of life of both the patients and their families. While the exact cause of ASD still remains unclear, it is proposed to be a complex interaction between genetic and environmental factors, and the immune system plays a role in responding to such factors. The use of intravenous immunoglobulin (IVIG) has been shown to be effective in a number of immune disorders, however, its role in ASD management still remains undefined. Evidence shows that low immunoglobulin (Ig) level is related to increased ASD symptoms, but no studies have connected such relationship to any specific drug therapy to the best of our knowledge.Objectives: To evaluate the use of IVIG as a potential therapy for ASD symptoms management in patients who have coexisting immune system disorder, specifically in those with low IgG and IgM levels.Methods: This is a retrospective case study which utilizes patients who receive long-term IVIG therapy at an outpatient setting from the American Outcomes Management. Three patients who have ASD diagnosis with co-existing immune system disorder(s) were selected; their medical reports, skilled nursing visit reports, and doctor’s progress notes were used as surrogate endpoints to measure their ASD disease progress and treatment outcomes throughout a five to eight years course of IVIG therapy.Results: Long-term IVIG therapy restored patients’ IgG and IgM levels, and such findings directly correlate with an improvement in ASD symptoms. IVIG is a potential therapy option to manage ASD symptoms in patients who have immune system disorder with low IgG and IgM levels. This result illustrates that as opposed to insurance’s denials of using IVIG for ASD, IVIG indeed plays a role in ASD management, and hopefully further research will be done in this area to validate the establishment of its clinical role.Conclusions: This is the first time IVIG is tied to ASD patients who have immune system disorder with low IgG and IgM levels. There is a case here to address third party denials of IVIG in ASD patients with low IgG and IgM levels. Large trials may be necessary to buttress this point.