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Serum IgG levels in IV immunoglobulin treated chronic inflammatory demyelinating polyneuropathy
  1. Krista Kuitwaard1,
  2. Pieter A van Doorn1,
  3. Marinus Vermeulen2,
  4. Leonard H van den Berg3,
  5. Esther Brusse1,
  6. Anneke J van der Kooi2,
  7. W-Ludo van der Pol3,
  8. Ivo N van Schaik2,
  9. Nicolette Notermans3,
  10. Anne P Tio-Gillen1,4,
  11. Wouter van Rijs1,4,
  12. Teun van Gelder5,
  13. Bart C Jacobs1,4
  1. 1Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
  2. 2Department of Neurology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  3. 3Department of Neurology Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands
  4. 4Departments of Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
  5. 5Department of Hospital Pharmacy, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
  1. Correspondence to Dr Krista Kuitwaard, Department of Neurology, Erasmus MC, University Medical Center Rotterdam, Room Ee-2230, P.O. Box 2040, Rotterdam 3000 CA, The Netherlands; k.kuitwaard{at}erasmusmc.nl

Abstract

Objective To determine the variability of serum IgG in patients with chronic inflammatory demyelinating polyneuropathy (CIDP).

Methods All 25 CIDP patients had active but stable disease and were treated with individually optimised fixed dose IVIg regimens. IgG was measured by turbidimetry and variability was defined as coefficient of variation (CV).

Results The intra-patient variability of the pre-treatment IgG levels, post-treatment levels and increase in serum IgG shortly after IVIg (ΔIgG) was low (mean CV=3%, 4%, 10%). The inter-patient variability between patients treated with the same dose and interval was low in pre-treatment, post-treatment and ΔIgG level (mean CV=13%, 11%, 20%). The ΔIgG levels were associated with IVIg dosage (rs=0.78, p<0.001).

Conclusions Clinically stable CIDP patients show a steady-state in serum IgG after serial IVIg infusions. The low intra- and inter-patient variability in IgG may indicate that constant levels are required to reach this stability.

  • Clinical neurology
  • Neuromuscular
  • Neuroimmunology
  • Pharmacokinetics
  • Peripheral neuropathology

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