Intravenous immune globulin effective treatment for GBS, CIDP

Intravenous immune globulin (IVIg) is an effective treatment for certain disorders of the nerve and muscles, including Guillain-Barré syndrome (GBS) and a form of neuropathy called chronic inflammatory demyelinating polyneuropathy (CIDP), according to a guideline issued by the American Academy of Neurology. The guideline is published in the March 27, 2012, print issue of Neurology®, the medical journal of the American Academy of Neurology.

IVIg is a type of immunotherapy that fights the misdirected immune system. It is not well understood exactly how IVIg works, but it likely regulates an overactive immune system. Immune globulin is a protein in human blood that likely links itself with antibodies or other substances directed at the nerve.

According to the guideline, strong evidence shows that IVIg effectively treats Guillain-Barré syndrome, a rare disorder in which the body's immune system attacks the peripheral nervous system, causing tingling and weakness in the arms and legs. The evidence shows that IVIg works as well as the treatment called plasma exchange to treat GBS.

Strong evidence also shows that long-term use of IVIg can help treat CIDP, which is the chronic counterpart of GBS and can affect nerves in the arms and legs and other parts of the body.

"Serious side effects are rare with IVIg, but there is a risk of kidney failure and a condition that causes the blood to be more likely to form clots," said guideline lead author Huned S. Patwa, MD, of Yale University and the VA Connecticut Healthcare System in West Haven and a member of the American Academy of Neurology. "It is important to work with your doctor when deciding whether to use IVIg for a neuromuscular disorder."

The guideline also found that IVIg is effective in helping to treat moderate to severe forms of myasthenia gravis and a rare condition known as multifocal motor neuropathy. It may also be helpful in treating neuromuscular disorders known as nonresponsive dermatomyositis and Lambert-Eaton myasthenic syndrome.

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