596 Application of Intravenous Immunoglobulin for Treatment of Chronic Autoimmune Urticaria

BACKGROUND: To develop a patogenetically justified method for treatment of the autoimmune form of chronic urticaria. METHODS: 14 patients with autoimmune urticaria (18–60 y-o., time since disease onset ranging from 6 weeks to 5 years), having positive autoserum test results (7 mm or more in 11 patients, 4.5–6.5 mm in 3 patients) were treated with intravenous immunoglobulin for 4 days (50 mL of 5% immunoglobulin solution per day). Intravenous immunoglobulin of a fourth generation, containing 99.1 to 99.2% monomeric IgG, was applied. RESULTS: The treatment resulted in the rashes regressing in 13 (93%) patients after 3 to 4 days of treatment. All of the patients showed reduced autoserum test results (one of them was absolutely negative) 6 months after the end of treatment. Our investigations have shown a complete absence of clinical manifestations of urticaria within 1 year. CONCLUSIONS: Intravenous immunoglobulin, containing only monomeric IgG, has proven highly efficient in treatment of chronic autoimmune urticaria. The above-mentioned reduced autoserum test results suggest fourth-generation intravenous immunoglobulin's contribution to the pathogenesis of the disease.