Intravenous immunoglobulin

Our search revealed no RCTs. We found a single case series of more than five patients that investigated the use of IVIG in the treatment of pemphigus. The study by Harman and Black37 describes 14 patients with autoimmune blistering disorders who were treated with IVIG in conjunction with their previous therapy. Seven of these patients had pemphigus vulgaris.

Most patients had disease that was partially controlled with prednisolone with or without immunosuppressive agents. Patients received up to five IVIG treatments, 0.4 g/kg given on consecutive days. The addition of IVIG appeared to suppress blistering in two patients with pemphigus in whom the disease was severe and progressing rapidly. The other patients with pemphigus experienced some benefit initially, but the effect became less pronounced with subsequent treatments; all patients experienced a relapse within 6 weeks. All patients remained on medication. There was no mortality. Side-effects resulting from IVIG therapy were minimal.

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