High Doses of Antigen-Nonspecific IgG do not Inhibit Pemphigus Acantholysis in Skin Organ Cultures
A patient suffering from severe pemphigus vulgaris was treated by large volume plasma exchange in combination with an immunosuppressive regimen (corticosteroids and azathioprine . In addition, she was given high doses of polyclonal, polyspecific human IgG (0.5 g Sandoglobulin/kg, Table 1) through the i.v. route (IGIV) at the end of each plasma exchange session to restore depleted humoral antibodies and thus reduce the danger of infections. Recent reports show evidence that IGIV protect target plateles in idiopathic thrombocytopenic purpura from attack by anti-plateled auto-antibodies and/or immune complexes [3, 6] and therefore we hoped that this therapeutic measure might yield additional benefits, such as nonspecific displacement of the autoantibody from its epidermal target (“coating” of the antigen) , or blocking of anti-epidermal autoantibodies by complex formation with so called public antiidiotypes present in IGIV .
KeywordsPlasma Exchange Idiopathic Thrombocytopenic Purpura Immunosuppressive Regimen Skin Explants Organ Culture Model
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