Effect of High-Dose Intravenous Immunoglobulin Administration on the Levels of Interleukin-6 in Patients with Sepsis

Background: Intravenous immunoglobulin (IVIG) is administered to patients with sepsis to improve clinical outcomes. Here, we report the effectiveness of highdose IVIG therapy in patients with sepsis admitted to a teaching hospital.

Methods: We analyzed 55 patients admitted to intensive care unit (ICU) due to sepsis. The patients were categorized into 2 groups depending on their IVIG dose: Patients administered high-dose (15 g/day for 3 days; total of 45 g) sulfonated human IVIG were designated the HD group, and those administered a standard divided dose (5 g/day for 3 days; total of 15 g) were designated the S group. The courses of interleukin (IL)-6 values were examined.

Results: The HD and S groups comprised 13 and 42 patients, respectively. The Log10 IL-6 values on Day 1 for HD and S groups were 3.3 ± 1.0 pg/mL and 3.4 ± 0.9 pg/mL (p=0.79). The repeated two-way ANOVA revealed no statistical inter-group difference for time course between 2 groups (p=0.42). The median Sequential Organ Failure Assessment (SOFA) scores on the day of ICU admission of the HD and S groups were 13.0 and 11.0, respectively (p=0.03). The most frequency of infection sources was abdomen in two groups, and there was no statistical difference for infection sources (p=0.18). The 28 day mortality rates for the HD and S groups were 30.8% and 14.3% (p=0.17), respectively.

Conclusion: This study showed that IVIG dose had no significant effect on IL-6 values despite of slightly lower course in high-dose IVIG group.

Author(s):

Munenori Kusunoki, Kenichiro Nishi, Takeshi Umegaki, Takeo Uba, Akihisa Okamoto, Nobuyuki Hamano and Kiichi Hirota

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