소아 아토피피부염에서 정맥용 면역글로블린 사용 효과

Abstract

Objective: Atopic dermatitis (AD) is a chronic inflammatory skin disease with significant morbidity, and for which there is a need for safe and effective alternative therapies. Although a few observations on the efficacy of intravenous immunoglobulin (IVIG) in AD have been reported, clinical evidence of effectiveness from controlled trials is lacking. Therefore, the purpose of this study was to clarify whether IVIG therapy (1.0 g/kg body weight at each monthly visit for 6 months) is effective in childhood atopic dermatitis and to analyze the clinical characteristics of IVIG responses in this disease. Methods: Forty three atopic dermatitis patients who had characteristic clinical features of atopic dermatitis were included in this study. The patients received an injection of IVIG at 1.0 g/kg body weight at each monthly visit for 6 months. Laboratory tests were performed for blood chemistry, total immunoglobulin E, immunoglobulin G/immunoglobulin A/immunoglobulin M, blood eosinophil count, and C-reactive protein. Results: In total forty three atopic dermatitis patients, only 14 patients completely underwent 6 cycles, but other 29 patients incompletely (1–5 cycles). In the 14 patients, there were just 13 records of scoring atopic dermatitis (SCORAD) index. The mean SCORAD score in the 13 patients was 39.6±24.4. SCORAD score decreased significantly (initial SCORAD, 39.6±24.4; final SCORAD, 21.3±15.6; P=0.016). Conclusion: IVIG therapy may be recommended in the treatment of recalcitrant atopic dermatitis. In addition, further investigation on predictive markers for responses of IVIG therapy in atopic dermatitis may be needed.