A controlled study of intravenous immunoglobulin in demyelinating neuropathy with IgM gammopathy
A controlled study of intravenous immunoglobulin in demyelinating neuropathy with IgM gammopathy
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DOI：
10.1002/ana.410400516
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发表时间：
1996-11-01
影响因子：
11.2
通讯作者：
Otero, C
中科院分区：
文献类型：
--
作者：
Dalakas, MC;Quarles, RH;Otero, C
在一项双盲研究中，11例与单克隆IgM抗体相关的脱髓鞘性多发性神经病患者随机接受IVIg或安慰剂治疗，每月一次，持续3个月。经过一段洗脱期后，他们转向替代疗法。通过评估基线、3个月后和治疗结束时的肌力、感觉和神经肌肉症状来衡量反应。在IVIg治疗后，11名患者中只有2名患者的强度得到改善，分别较基线提高了28分和38.5分，而安慰剂治疗后则有所下降。另1例患者感觉评分改善13分。MAG/SGPG或神经节苷脂的抗体滴度没有明显变化。我们的结论是镁只有一个温和的好处，不超过18%的IgM副蛋白血症脱髓鞘神经病变的患者。
Eleven patients with demyelinating polyneuropathy associated with monoclonal IgM antibodies were randomized to receive IVIg or placebo, monthly, for 3 months in a double-blind study. After a washout period, they crossed over to the alternate therapy. Response was gauged by evaluating muscle strength, sensation, and neuromuscular symptoms at baseline, after 3 months, and at treatment's end. After IVIg therapy, the strength improved in only 2 of 11 patients, by 28 and 38.5 points from baseline, and declined after placebo. In 1 other patient, the sensory score improved by 13 points. Antibody titers to MAG/SGPG or gangliosides did not appreciably change. We conclude that Mg has only a modest benefit to not more than 18% of patients with IgM paraproteinemic demyelinating neuropathy.