Use of Human Intravenous Immunoglobulin in Veterinary Clinical Practice

Spurlock, Nicole; Prittie, Jennifer

doi:10.1016/j.cvsm.2020.07.015

Cited by 7 publications

(22 citation statements)

References 42 publications

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“… 7 Use of hIVIG in human medicine also has been reported to prevent hemolysis associated with sickle cell disease, and for blood transfusion in patients with lymphoma. 1 Similarly, in veterinary medicine hIVIG has been used for several diseases, 2 , 8 including immune‐mediated hemolytic anemia (IMHA), 9 , 10 , 11 , 12 , 13 immune‐mediated thrombocytopenia, 14 , 15 , 16 cutaneous drug reactions, 17 , 18 and myasthenia gravis. 19 …”

Section: Introductionmentioning

confidence: 99%

The use of high‐dose immunoglobulin M‐enriched human immunoglobulin in dogs with immune‐mediated hemolytic anemia

Bestwick

Sharman

Whitley³

et al. 2021

Veterinary Internal Medicne

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Background The IV use of human immunoglobulin (hIVIG) in dogs with primary immune‐mediated hemolytic anemia (IMHA) has been described previously, but herein we describe the use of high‐dose IgM‐enriched hIVIG (Pentaglobin). Hypothesis/Objectives Dogs treated with high‐dose Pentaglobin will experience shorter time to remission and hospital discharge and have decreased transfusion requirements compared to dogs receiving standard treatment alone. Animals Fourteen client‐owned dogs diagnosed with primary IMHA at specialist referral hospitals in the United Kingdom. Methods All prospectively enrolled dogs received prednisolone, dexamethasone or both along with clopidogrel. Patients were randomized to receive Pentaglobin at 1 g/kg on up to 2 occasions, or to serve as controls. No additional immunosuppressive drugs were allowed within the first 7 days of treatment. Remission was defined as stable PCV for 24 hours followed by an increase in PCV. Results Ten of 11 dogs from the treatment group and 2 of 3 dogs from the control group achieved remission and survived until hospital discharge. Survival and time to remission were not significantly different between groups. The volume of packed red blood cells transfused, normalized for body weight, was not significantly different between groups. Potential adverse reactions to Pentaglobin occurred in 2 dogs, but their clinical signs may have been related to the underlying disease. Conclusions and Clinical Importance Treatment with high‐dose Pentaglobin was well tolerated by dogs with primary IMHA but no significant advantage was found in this small study. Additional studies examining larger groups and subpopulations of dogs with primary IMHA associated with a poorer prognosis are warranted.

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Section: Introductionmentioning

confidence: 99%

The use of high‐dose immunoglobulin M‐enriched human immunoglobulin in dogs with immune‐mediated hemolytic anemia

Bestwick

Sharman

Whitley³

et al. 2021

Veterinary Internal Medicne

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“…As with any case report, causation cannot be proven, and as such, the reader should bear in mind that the administered hIVIG might not have resulted in the clinical responses observed in these two cats. Adverse effects associated with hIVIG are infrequently reported in the veterinary literature, and this drug is generally considered safe 13 . Both cats reported herein tolerated the infusions without any noticeable adverse effects, during or following the administration of hIVIG.…”

Section: Discussionmentioning

confidence: 68%

“…A prospective clinical trial, evaluating the use of hIVIG with glucocorticoids in 28 dogs with non‐associative IMHA, concluded that for initial treatment, the addition of hIVIG did not result in improved responses or a survival benefit, nor did it shorten the duration of hospitalisation or resulted in reduced transfusion requirements, when compared to glucocorticoids alone 19 . The small number of patients in that study, however, was a limitation and might have impacted the results 13,19 . Currently, hIVIG given as a single infusion at a dose of 0.5–1 g/kg is recommended only as a salvage treatment in dogs with IMHA that have not responded to standard treatment with two immunosuppressive drugs 10 …”

Section: Discussionmentioning

confidence: 99%

“…A previous prospective study, evaluating hIVIG in 10 dogs with IMHA unresponsive to immunosuppressive therapy, concluded that hIVIG was of benefit in dogs that did not develop an increase in PCV within 7 days of starting glucocorticoid treatment 17 . However, the study lacked a control population, which makes interpretation of the results challenging 13,17 . Another study that assessed 88 dogs with non‐associative IMHA, which received various treatments including hIVIG, also concluded that its use for the treatment of IMHA might be beneficial 18,19 .…”

Section: Discussionmentioning

confidence: 99%

“…19 The small number of patients in that study, however, was a limitation and might have impacted the results. 13,19 Currently, hIVIG given as a single infusion at a dose of 0.5-1 g/kg is recommended only as a salvage treatment in dogs with IMHA that have not responded to standard treatment with two immunosuppressive drugs. 10 There is very limited information in the literature regarding the use of hIVIG in cats.…”

Section: Discussionmentioning

confidence: 99%

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Use of human intravenous immunoglobulin for treatment of immune‐mediated haemolytic anaemia in two cats

Baptista

Kelly

2022

Vet Record Case Reports

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A 2‐year‐old male neutered Maine Coon cat (Cat 1) presented to a referral centre with a 1‐day history of lethargy. A 3‐year‐old male neutered domestic shorthair cat (Cat 2) presented with a 1‐week history of inappetence and lethargy. Complete blood count revealed a severe, mildly regenerative, normocytic, normochromic anaemia for Cat 1, and a severe, non‐regenerative normocytic normochromic anaemia for Cat 2. Following further investigations, a diagnosis of non‐associative immune‐mediated haemolytic anaemia was made. Treatment with immunosuppressive dosages of glucocorticoids was started; however, given the lack of response and severity of disease in both cases, it was decided to administer human intravenous immunoglobulin. There was improvement of haematocrit 2 days following the infusion for Cat 1, and 5 days after for Cat 2. Both cats were discharged from the hospital. Cat 1 remained in remission 6 months following the diagnosis, and Cat 2 was lost to follow‐up.

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Suspected pregnancy‐associated meningoencephalitis of unknown origin in a dog

Aguilera‐Padros,

Kelley,

Dancer

et al. 2023

Vet Record Case Reports

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A 1‐year 5‐month‐old, female, entire Parson Russell terrier was referred for investigations of focal epileptic seizures and behavioural changes. The clinical signs started 4 days after whelping its first litter. On presentation, the neurological examination was unremarkable. Neuroanatomical localisation was the forebrain. A brain magnetic resonance imaging showed bilateral, asymmetric, intra‐axial, T2‐weighted and fluid‐attenuated inversion recovery hyperintense, T1‐weighted hypointense, mildly to non‐contrast‐enhancing lesions in the piriform cortex. Cerebrospinal fluid analysis was within normal limits, and main infectious diseases were ruled out. Based on the presentation, findings and progression of clinical signs, a meningoencephalitis of unknown origin was suspected. In the present case, a positive response to immunosuppressive medication was observed. A well‐established link between pregnancy and immune‐mediated diseases, including meningoencephalitis, has been described in humans. This connection could have been the reason of the clinical signs, and this is supported by the recent pregnancy, presentation and positive response to immunosuppressive medication.

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Use of Human Intravenous Immunoglobulin in Veterinary Clinical Practice

Cited by 7 publications

References 42 publications

The use of high‐dose immunoglobulin M‐enriched human immunoglobulin in dogs with immune‐mediated hemolytic anemia

The use of high‐dose immunoglobulin M‐enriched human immunoglobulin in dogs with immune‐mediated hemolytic anemia

Use of human intravenous immunoglobulin for treatment of immune‐mediated haemolytic anaemia in two cats

Suspected pregnancy‐associated meningoencephalitis of unknown origin in a dog

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