Сorrection of patients’ immune status with human intravenous immunoglobulin

Abstract

The article is dedicated to administration of human intravenous immunoglobulin for patients with different pathology accompanied by immunity disorders. Pharmacokinetics of human intravenous immunoglobulin and mechanisms of its action are presented in detail. Capabilities for its use as replacement (in immunodeficiencies, agammaglobulinemia) and immunomodulatory therapy (in autoimmune disorders) are discussed. We present algorithms for correction treatment with intravenous immunoglobulin of lymphoproliferative diseases (such as chronic lymphocytic leukemia, non-Hodgkin lymphoma, multiple myeloma), patients after hematopoietic stem cell transplantation with recurrent infections, patients with different autoimmune diseases including systemic collagenosis (systemic lupus erythematosus, systemic vasculitis, systemic sclerosis), autoimmune agranulocytosis, immune thrombocytopenia. Capability for the use of intravenous immunoglobulin is considered for treatment of different septic, septicotoxemic complications, herpetic infections (cytomegalovirus infection, infection caused by Epstein-Barr virus) occuring in oncology, surgical and obstetric practice as well as for complex treatment of sepsis including in neonates. The article presents in detail the used doses of intravenous immunoglobulin and methods of its infusion for different groups of diseases. Timely administration of intravenous immunoglobulin in optimal doses allows reducing the duration of treatment of active infection in patients with immunosuppresion of different causes, bleeding in immune thrombocytopenia, intensity of autoimmune disease manifestation as well as reducing the risk of severe infection in innate and acquired agammaglobulinemia without serious adverse effects.