• Journal of Veterinary Clinics
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• v.30 no.1
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• pp.61-65
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• 2013

An American Cocker Spaniel (3-year-old, intact female, 6.0 kg) was referred to the Veterinary Medical Teaching Hospital of Chungnam National University for evaluation of pustules and crusts in the periocular region, dorsal and ventral region of the trunk, and digits. Complete blood count (CBC) revealed leukocytosis with mature neutrophilia, and a serum biochemistry profile revealed hypoalbuminemia. Tape strip tests identified numerous neutrophils and acatholytic cells. Histopathology identified intraepithelial pustules with neutrophils and acantholytic keratinocytes. Definitive diagnosis of pemphigus foliaceus (PF) was made by direct immunofluorescence (DIF) test with goat anti-canine IgG antibody. The human intravenous immunoglobulin (IVIG) was administered at a rate of 15 ml/h over 6 hours for 4 days. After that, the dog was maintained on prednisolone (2.2 mg/kg, PO, SID) and azathioprine (2.0 m/kg, PO, SID). An infusion of IVIG (0.5 g/kg) was repeated 3 days after 4 weeks. After 10 weeks, the dog showed the remarkable regression of lesions.

• Childhood Kidney Diseases
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• v.12 no.2
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• pp.233-238
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• 2008

It has been suspected that various infections, including cytomegalovirus(CMV) infection, are associated with IgA nephropathy. In case of CMV infection, ganciclovir is known to be a treatment of choice for severe CMV infection in general. But ganciclovir has a lot of severe toxicity, so children with normal immunity are seldom treated by ganciclovir when CMV infection is suspected. On the other hand, intravenous immunoglobulin can also be used to treat CMV infection. We report a case of CMV-associated IgA nephrophaty, who was treated with deflazacort and Intravenous immunoglobulin therapy. An 11 years old boy suffered from gross hematuria for 3 days. He had proteinuria, thrombocytopenia(104,000/$mm^3$), antiplatelet antibody(＋), impaired renal function and low serum albumin. His CMV serology was CMV-IgM/IgG(＋/-) and urine CMV-PCR was positive. The renal histological findings revealed IgA nephropathy, WHO class II. His proteinuria persisted despite of deflazacort therapy(2.5 mg/kg/day). Later, intravenous immunoglobulin(1 g/kg) was administered twice. In two years, he showed no gross and microscopic hematuria, and his laboratory findings were also normalized.

• Clinical and Experimental Reproductive Medicine
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• v.44 no.1
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• pp.1-7
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• 2017

The task force of the Korean Society for Reproductive Immunology recommends intravenous immunoglobulin G treatment in women with reproductive failure, including recurrent pregnancy loss and/or repeated implantation failure, who show cellular immune factors such as abnormal natural killer cell levels, natural killer cell cytotoxicity, and/or type 1 T helper immunity.

• Annals of Clinical Neurophysiology
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• v.8 no.1
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• pp.48-52
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• 2006

Background: Intravenous immunoglobulin (IVIg) has been administered for various immune-mediated neurological diseases such as autoimmune neuropathy, inflammatory myopathies, and other autoimmune neuromuscular disorders. The purpose of this study is to investigate side effects and complications of IVIg therapy in neuromuscular disorders. Methods: We enrolled 29 patients (age 8~63 years) with IVIg therapy for various neurological diseases including Guillain-Barre syndrome, myasthenia gravis, dermatomyositis, polymyositis, chronic inflammatory demyelinating polyneuropathy, and multifocal motor neuropathy. IVIg therapy was used at a dose of 0.4 g/kg body weight/day for 5 consecutive days. Results: 10 patients (34%) had adverse events. There are adverse events in 16 courses (11%) among total 145 courses. The majority of patients presented with mild side effects, mostly asymptomatic laboratory changes. Rash or mild headache occurred in 3 patients. One patient showed a serious side effect of deep vein thrombosis. Conclusions: IVIg therapy is safe for a variety of immune-mediated neurological diseases in our study.

• Journal of Yeungnam Medical Science
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• v.30 no.1
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• pp.21-24
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• 2013

Hemolytic disease in a newborn that causes early jaundice is common. It is often due to the Rh (D) and ABO incompatibility, but rarely due to unexpected antibodies. Among these unexpected antibodies, the anti-$Di^a$Dia antibody rarely occurs. The anti-$Di^a$ antibody was observed in the serum and red-cell eluate of an infant, and in the serum of his mother. The frequency of the appearance of the $Di^a$ antigen in the Korean population is estimated to be 6.4-14.5%. This paper reports a case of hemolytic disease in a newborn associated with the anti-$Di^a$ antibody. A full-term male infant was transferred to the authors' hospital due to hyperbilirubinemia the day after his birth. The laboratory data indicated a hemoglobin value of 11.6 g/dL, a reticulocyte count of 10.6%, a total bilirubin count of 14.4 mg/dL, a direct bilirubin count of 0.6 mg/dL, and a positive result in the direct Coombs' test. Due to the identification of an irregular antibody from the maternal serum, an anti-$Di^a$ antibody was detected, which was also found in the eluate made from the infant's blood. The infant had been treated with phototherapy and intravenous immunoglobulin since the second day after his birth and was discharged due to an improved condition without exchange transfusion. Therefore, in cases of iso-immune hemolytic disease in a newborn within 24 hours from birth who had a negative result in an antibody screening test, the conduct of an anti-$Di^a$ antibody identification test is recommended due to the suspicion of an anti-$Di^a$ antigen, followed by early administration of intravenous immunoglobulin.

• Clinical and Experimental Reproductive Medicine
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• v.32 no.1
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• pp.1-8
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• 2005

• Clinical and Experimental Pediatrics
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• v.46 no.8
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• pp.817-820
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• 2003

Purpose : Intravenous immunoglobulin(IVIG) has been used as an immunomodulatory treatment for several immune-mediated diseases. The early effect of high-dose IVIG on biochemical profiles including lipids and proteins was evaluated in patients with Kawasaki disease(KD). Methods : Twelve children with KD(nine boys) were treated with IVIG of 2 g/kg over 12 hours. Serial sera were collected from the patients four times : before IVIG treatment and two hours, 24 hours and seven days after IVIG treatment. The samples were frozen at $-20^{\circ}C$ before biochemical analysis. Results : A significant decrease in albumin concentration was found two hours h and 24 hours after IVIG treatment, but this recovered to the pretreatment level after seven days. Total cholesterol and triglyceride increased slightly after seven day. A significant decrease in HDL-cholesterol and C-reactive protein was seen two hours and 24 hours after IVIG treatment. Conclusion : High-dose IVIG affects immediate changes in protein profiles and HDL-cholesterol in KD. Changes in HDL-cholesterol induced by IVIG may be the result of changes in systemic protein metabolism.

• Clinical and Experimental Pediatrics
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• v.59 no.sup1
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• pp.60-63
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• 2016

Herein, we report a rare case of hemolytic anemia with reticulocytopenia following intravenous immunoglobulin therapy in a young infant treated for Kawasaki disease. A 2-month-old boy presented with fever lasting 3 days, conjunctival injection, strawberry tongue, erythematous edema of the hands, and macular rash, symptoms and signs suggestive of incomplete Kawasaki disease. His fever resolved 8 days after treatment with aspirin and high dose infusion of intravenous immunoglobulin. The hemoglobin and hematocrit decreased from 9.7 g/dL and 27.1% to 7.4 g/dL and 21.3%, respectively. The patient had normocytic hypochromic anemia with anisocytosis, poikilocytosis, immature neutrophils, and nucleated red blood cells. The direct antiglobulin test result was positive, and the reticulocyte count was 1.39%. The patient had an uneventful recovery. However, reticulocytopenia persisted 1 month after discharge.

• Korean Journal of Veterinary Research
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• v.56 no.3
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• pp.139-145
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• 2016

This study was conducted to determine the effect of treatment with intravenous human immunoglobulin G (hIVIgG) on outcome in dogs with idiopathic immune-mediated hemolytic anemia (IMHA), and to identify prognostic variables that determine outcome in affected dogs. Thirty-seven dogs that met the inclusion criteria were enrolled in a retrospective study. The dogs were categorized into two groups based on their having received hIVIgG. There was no significant difference in survival between the hIVIgG group and the non-hIVIgG group. Mortality during hospitalization and at 1 month, 1 year, or 2 years after discharge was not significantly different between the hIVIgG and the non-hIVIgG groups. Hemoglobinuria was significantly less prevalent in dogs that lived more than 1 year than in those who lived less than 1 year, and was less prevalent in dogs that lived more than 2 years than in those who lived less than 2 years. However, there was no difference in the presence of hemoglobinuria between dogs that lived less than 1 month and those that lived more than 1 month. Overall, there was no evidence of a beneficial effect of hIVIgG in dogs with idiopathic IMHA.

• Clinical and Experimental Pediatrics
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• v.59 no.4
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• pp.178-182
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• 2016

Purpose: Medium-dose (1 g/kg) intravenous immunoglobulin (IVIG) is effective in the majority of patients with Kawasaki disease (KD) but some patients who do not respond to medium-dose IVIG are at high risk for the development of coronary artery lesions (CALs). The purpose of this study was to identify the clinical predictors associated with unresponsiveness to medium-dose IVIG and the development of CALs. Methods: A retrospective study was performed in 91 children with KD who were treated with mediumdose IVIG at our institution from January 2004 to December 2013. We classified the patients into responders (group 1; n=68) and nonresponders (group 2; n=23). We compared demographic, laboratory, and echocardiographic data between the 2 groups. Results: Multivariate logistic regression analysis identified 6 variables as predictors for resistance to medium-dose IVIG. We generated a predictive scoring system assigning 1 point each for percentage of neutrophils ${\geq}65%$, C-reactive protein ${\geq}100mg/L$, aspartate aminotransferase ${\geq}100IU/L$, and alanine aminotransferase ${\geq}100IU/L$, as well as 2 points for less than 5 days of illness, and serum sodium level ${\leq}136mmol/L$. Using a cutoff point of ${\geq}4$ with this scoring system, we could predict nonresponsiveness to medium-dose IVIG with 74% sensitivity and 71% specificity. Conclusion: If a patient has a low-risk score in this system, medium-dose IVIG can be recommended as the initial treatment. Through this process, we can minimize the adverse effects of high-dose IVIG and incidence of CALs.