Autologous immunoglobulin therapy in patients with severe recalcitrant atopic dermatitis: a preliminary report.

Abstract

The management of severe recalcitrant atopic dermatitis (AD) is a challenging

issue for clinicians and patients. We hypothesized that repeated intramuscular

injections of autologous immunoglobulin (autologous immunoglobulin therapy: AIGT)

might induce clinical improvements in patients with AD by stimulation of the

active immune response to antigen-binding-site of pathogenic antibodies. We tried

AIGT in 3 adult patients with severe recalcitrant AD whose clinical conditions

could not be effectively controlled by medical treatments (including oral

cyclosporine) for more than 2 years. Autologous immunoglobulin was purified from

the autologous plasma by affinity chromatography using Protein A. The patients

were treated by an intramuscular injection of 50 mg of autologous immunoglobulin

twice a week for 4 weeks. A clinical severity score of AD (SCORAD value) showed a

decrease greater than 30% at 8 weeks after the initiation of AIGT compared with

the baseline before the initiation of AIGT in all 3 patients with severe

recalcitrant AD. No significant side effects from treatment were observed.

Further studies with larger numbers of patients are required to evaluate the

clinical usefulness of AIGT for AD.