The production processes and biological effects of intravenous immunoglobulin

Biomolecules

Volumn 6, Issue 1, 2016, Pages

  Afonso, Ana Filipa Barahona ^a   João, Cristina Maria Pires ^b  

^a UNIVERSITY OF ÉVORA   (Portugal)

^b CHAMPALIMAUD CENTRE FOR THE UNKNOWN   (Portugal)

Author keywords

Immune modulation; Immunoglobulin; IVIg; IVIg production; Molecular mechanisms

Indexed keywords

ALBUMIN; ALPHA GLOBULIN; BETA GLOBULIN; BLOOD CLOTTING FACTOR 8; CLASSICAL COMPLEMENT PATHWAY C3 C5 CONVERTASE; COMPLEMENT COMPONENT C3B; COMPLEMENT COMPONENT C4B; FAS ANTIGEN; FC RECEPTOR; FC RECEPTOR IIB; FIBRINOGEN; IMMUNOGLOBULIN; IMMUNOGLOBULIN A; IMMUNOGLOBULIN E; IMMUNOGLOBULIN G3; IMMUNOGLOBULIN G4; INTERLEUKIN 1; INTERLEUKIN 10; INTERLEUKIN 2; INTERLEUKIN 3; INTERLEUKIN 4; INTERLEUKIN 5; INTRINSIC FACTOR; LIPOPROTEIN; NEUTRALIZING ANTIBODY; NEUTROPHIL CYTOPLASMIC ANTIBODY; PLASMA PROTEIN; THYROGLOBULIN; UNINDEXED DRUG; ANTINEOPLASTIC AGENT;

ACUTE KIDNEY FAILURE; ALLOTRANSPLANTATION; ANAPHYLAXIS; ANTIBODY PRODUCTION; ARTHRALGIA; ASEPTIC MENINGITIS; B LYMPHOCYTE; CANCER PATIENT; CARDIOVASCULAR DISEASE; CELL PROLIFERATION; CHEMORADIOTHERAPY; CHEST TIGHTNESS; CHILL; CHROMATOGRAPHY; COMPLEMENT INHIBITION; CYANOSIS; DENDRITIC CELL; DIZZINESS; DYSPNEA; FATIGUE; FEVER; GASTROINTESTINAL DISEASE; GRAFT VERSUS HOST REACTION; HEADACHE; HEART PALPITATION; HEMATOLOGIC DISEASE; IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME; IMMUNITY; IMMUNOGLOBULIN DEFICIENCY; INFUSION RELATED REACTION; INTRACELLULAR SIGNALING; LYMPHOCYTOPENIA; MIGRAINE; MUSCULOSKELETAL DISEASE; NAUSEA; NEOPLASM; NEUROLOGIC DISEASE; POLYNEUROPATHY; PROTEIN ANALYSIS; PROTEIN PURIFICATION; RECURRENT INFECTION; RESPIRATORY TRACT DISEASE; REVIEW; RIGOR; SEIZURE; T LYMPHOCYTE; TACHYCARDIA; VIRUS INACTIVATION; WHEEZING; ADVERSE EFFECTS; CELL SURVIVAL; CYTOLOGY; DRUG EFFECTS; HUMAN; ISOLATION AND PURIFICATION; LYMPHOPENIA; RADIOTHERAPY;

ANTINEOPLASTIC AGENTS; CELL PROLIFERATION; CELL SURVIVAL; HUMANS; IMMUNOGLOBULINS, INTRAVENOUS; LYMPHOPENIA; RADIOTHERAPY; T-LYMPHOCYTES;

EID: 85012070557     PISSN: None     EISSN: 2218273X     Source Type: Journal    
DOI: 10.3390/biom6010015     Document Type: Review

References (164)

1. Von Behring, E. Untersuchungen ueber das Zustandekommen der Diphtherie-Immunitat bei Thieren (in Germany). Dtsch. Med. Wochenschr. 1890, 16, 1145-1148.
2. Von Behring, E.; Kitasato, S. Ueber das Zustandekommen der Diphtherie-Immunitat und der Tetanus-Immunitat bei Thieren (in Germany). Dtsch. Med. Wochenschr. 1890, 16, 1113-1114.
3. Bruton, O.C. Agammablobulinemia. Pediatrics 1952, 9, 722-728. [PubMed]
4. Imbach, P.; Barandun, S.; Baumgartner, C.; Hirt, A.; Hofer, F.; Wagner, H.P. High-dose intravenous gammaglobulin therapy of refractory, in particular idiopathic thrombocytopenia in childhood. Helv. Paediatr. Acta 1981, 36, 81-86. [PubMed]
5. Radosevich, M.; Burnouf, T. Intravenous immunoglobulin G: Trends in production methods, quality control and quality assurance. Vox Sang. 2010, 98, 12-28. [CrossRef] [PubMed]
6. Eibl, M.M. History of immunoglobulin replacement. Immunol. Allergy Clin. North Am. 2008, 28, 737-764. [CrossRef] [PubMed]
7. Nimmerjahn, F.; Ravetch, J.V. Anti-inflammatory actions of intravenous immunoglobulin. Annu. Rev. Immunol. 2008, 26, 513-533. [CrossRef] [PubMed]
8. Conley, M.E.; Dobbs, A.K.; Farmer, D.M.; Kilic, S.; Paris, K.; Grigoriadou, S.; Coustan-Smith, E.; Howard, V.; Campana, D. Primary B cell immunodeficiencies: Comparisons and contrasts. Annu. Rev. Immunol. 2009, 27, 199-227. [CrossRef] [PubMed]
9. Jung, D.; Giallourakis, C.; Mostoslavsky, R.; Alt, F.W. Mechanism and control of V(D)J recombination at the immunoglobulin heavy chain locus. Annu. Rev. Immunol. 2006, 24, 541-570. [CrossRef] [PubMed]
10. Durandy, A.; Kaveri, S.V.; Kuijpers, T.W.; Basta, M.; Miescher, S.; Ravetch, J.V.; Rieben, R. Intravenous immunoglobulins-Understanding properties and mechanisms. Clin. Exp. Immunol. 2009, 158, 2-13. [CrossRef] [PubMed]
11. Grayzel, A.; Solomon, A.; Aranow, C.; Diamond, B. Antibodies elicited by pneumococcal antigens bear an anti-DNA-associated idiotype. J. Clin. Investig. 1991, 87, 842-846. [CrossRef] [PubMed]
12. Knezevic-Maramica, I.; Kruskall, M.S. Intravenous immune globulins: An update for clinicians. Transfusion 2003, 43, 1460-1480. [CrossRef] [PubMed]
13. Looney, R.J.; Huggins, J. Use of intravenous immunoglobulin G (IVIG). Best Pract. Res. Clin. Haematol. 2006, 19, 3-25. [CrossRef] [PubMed]
14. Darabi, K.; Abdel-Wahab, O.; Dzik,W.H. Current usage of intravenous immune globulin and the rationale behind it: The Massachusetts General Hospital data and a review of the literature. Transfusion 2006, 46, 741-753. [CrossRef] [PubMed]
15. European Medicines Agency Guideline on the Clinical Investigation Of Human Normal Immunoglobulin For Intravenous Administration (IVIg). Available online: http://www.ema.europa.eu/ docs/en_GB/document_library/Scientific_guideline/2009/10/WC500004766.pdf (accessed on 22 August 2014).
16. Cohn, E.J.; Strong, L.E.; Hughes, W.L.; Mulford, D.J.; Ashworth, J.N.; Melin, M.; Taylor, H.L. Preparation and properties of serum and plasma proteins; a system for the separation into fractions of the protein and lipoprotein components of biological tissues and fluids. J. Am. Chem. Soc. 1946, 68, 459-475. [CrossRef] [PubMed]
17. Oncley, J.L.; Melin, M.; Richert, D.A.; Cameron, J.W.; Gross, P.M. The Separation of the antibodies, isoagglutinins, prothrombin, plasminogen and β1-lipoprotein into subfractions of human plasma. J. Am. Chem. Soc. 1949, 71, 541-550. [CrossRef] [PubMed]
18. European Medicines Agency Guideline on Core SmPC for human normal immunoglobulin for intravenous administration (IVIg). Available online: http://www.ema.europa.eu/docs/en_GB/ document_library/Scientific_guideline/2012/12/WC500136433.pdf (accessed on 22 August 2014).
19. Prins, C.; Gelfand, E.W.; French, L.E. Intravenous immunoglobulin: Properties, mode of action and practical use in dermatology. Acta Derm. Venereol. 2007, 87, 206-218. [PubMed]
20. Buchacher, A.; Iberer, G. Purification of intravenous immunoglobulin G from human plasma-Aspects of yield and virus safety. Biotechnol. J. 2006, 1, 148-163. [CrossRef] [PubMed]
21. European Medicines Agency Guideline on Epidemiological Data On Blood Transmissible Infections, Table of Contents. Available online: http://www.ema.europa.eu/docs/en_GB/document_library/ Scientific_guideline/2010/10/WC500097728.pdf (accessed on 22 August 2014).
22. European Medicines Agency Guideline on the Scientific Data Requirements for a Plasma Master File (PMF). Available online: http://www.ema.europa.eu/docs/en_GB/document_library/Scientific_guideline/2009/ 09/WC500003663.pdf (accessed on 22 August 2014).
23. European Medicines Agency Guideline on the Requirements for Plasma Master File (PMF) Certification. Available online: http://ec.europa.eu/health/files/eudralex/vol-2/c/466303en_08_2004_en.pdf (accessed on 22 August 2014).
24. Martin, T.D. IGIV: Contents, properties, and methods of industrial production-Evolving closer to a more physiologic product. Int. Immunopharmacol. 2006, 6, 517-522. [CrossRef] [PubMed]
25. Deutsch, H.F.; Gosting, L.J.; Alberty, R.A.;Williams, J.W. Biophysical studies of blood plasma proteins: III. Recovery of -globulin from human blood protein mixtures. J. Biol. Chem. 1946, 164, 109-118. [PubMed]
26. Hooper, J.A. Intravenous immunoglobulins: Evolution of commercial IVIG. Immunol. Allergy. Clin. N. Am. 2008, 28, 765-778. [CrossRef] [PubMed]
27. Cohn, E.J.; Gurd, F.R.N.; Surgenor, D.M.; Barnes, B.A.; Brown, R.K.; Derouaux, G.; Gillespie, J.M.; Kahnt, F.W.; Lever,W.F.; Liu, C.H.; et al. A system for the separation of the components of human blood: Quantitative procedures for the separation of the protein components of human plasma. J. Am. Chem. Soc. 1950, 72, 465-474. [CrossRef]
28. Peters, T.J., Jr. All About Albumin: Biochemistry, Genetics, and Medical Applications; Academic Press: San Diego, CA, USA, 1996.
29. Kistler, P.; Nitschmann, H.S. Large scale production of human plasma fractions. Eight years experience with the alcohol fractionation procedure of Nitschmann, Kistler and Lergier. Vox Sang. 1962, 7, 414-424. [CrossRef] [PubMed]
30. Chanutin, A.; Curnish, R.R. The precipitation of plasma proteins by short-chain fatty acids. Arch. Biochem. Biophys. 1960, 89, 218-220. [CrossRef]
31. Steinbuch, M.; Audran, R. The isolation of IgG from mammalian sera with the aid of caprylic acid. Arch. Biochem. Biophys. 1969, 134, 279-284. [CrossRef]
32. Lebing, W.; Remington, K.; Schreiner, C.; Paul, H. Properties of a new intravenous immunoglobulin (IGIV-C, 10%) produced by caprylate virus inactivation and column chromatography. Vox Sang. 2003, 84, 193-201. [CrossRef] [PubMed]
33. Polson, A.; Ruiz-Bravo, C. Fractionation of plasma with polyethylene glycol. Vox Sang. 1972, 23, 107-108. [CrossRef] [PubMed]
34. Falksveden, L.G.A. Method for fractionating plasma proteins using PEG and Ion-Exchangers. U.S. Patent 3869436 A, 4 March 1975.
35. Fahey, J.L.; Horbett, A.P. Human gamma globulin fractionation on anion exchange cellulose columns. J. Biol. Chem. 1959, 234, 2645-2651. [PubMed]
36. Baumstark, J.S.; Laffin, R.J.; Bardawil, W.A. A preparative method for the separation of 7S gamma globulin from human serum. Arch. Biochem. Biophys. 1964, 108, 514-522. [CrossRef]
37. Hoppe, H.; Mester, T.; Hennig,W.; Krebs, H. Prevention of rhimmunization. Modified production of IgG anti-Rh for intravenous application by ion-exchange chromatography (IEC). Vox Sang. 1973, 25, 308-316. [CrossRef] [PubMed]
38. Friesen, A.D.; Bowman, J.M.; Bees, W.C. Column ion exchange chromatographic production of human immune serum globulin for intravenous use. Vox Sang. 1985, 48, 201-212. [CrossRef] [PubMed]
39. Staby, A.; Sand, M.B.; Hansen, R.G.; Jacobsen, J.H.; Andersen, L.A.; Gerstenberg, M.; Bruus, U.K.; Jensen, I.H. Comparison of chromatographic ion-exchange resins. J. Chromatogr. A 2004, 1034, 85-97. [CrossRef] [PubMed]
40. Bertolini, J.; Davies, J.; Wu, J.; Coppola, G. Purification of immunoglobulins. U.S. Patent 6093324 A, 25 July 1998.
41. Burton, S.C.; Harding, D.R.K. Hydrophobic charge induction chromatography: Salt independent protein adsorption and facile elution with aqueous buffers. J. Chromatogr. A 1998, 814, 71-81. [CrossRef]
42. Tankersley, D.L.; Preston, M.S.; Finlayson, J.S. Immunoglobulin G dimer: An idiotype-anti-idiotype complex. Mol. Immunol. 1988, 25, 41-48. [CrossRef]
43. Razvi, S.; Schneider, L.; Jonas, M.M.; Cunningham-Rundles, C. Outcome of intravenous immunoglobulin-transmitted hepatitis C virus infection in primary immunodeficiency. Clin. Immunol. 2001, 101, 284-288. [CrossRef] [PubMed]
44. World Health Organization Guidelines on Viral Inactivation and Removal Procedures Intended to Assure the Viral Safety of Human Blood Plasma Products. Available online: http://apps.who.int/medicinedocs/ documents/s19651en/s19651en.pdf (accessed on 22 August 2014).
45. Wolf, H.H.; Davies, S.V.; Borte, M.; Caulier, M.T.; Williams, P.E.; Bernuth, H.V.; Egner, W.; Sklenar, I.; Adams, C.; Späth, P.; et al. Efficacy, tolerability, safety and pharmacokinetics of a nanofiltered intravenous immunoglobulin: Studies in patients with immune thrombocytopenic purpura and primary immunodeficiencies. Vox Sang. 2003, 84, 45-53. [CrossRef] [PubMed]
46. Korneyeva, M.; Hotta, J.; Lebing, W.; Rosenthal, R.S.; Franks, L.; Petteway, S.R. Enveloped virus inactivation by caprylate: A robust alternative to solvent-detergent treatment in plasma derived intermediates. Biologicals 2002, 30, 153-162. [CrossRef] [PubMed]
47. Kim, I.S.; Choi, Y.W.; Lee, S.R.; Cho, H.B.; Eo, H.G.;Woo, H.S.; Chang, C.E.; Lee, S. Improvement of virus safety of a human intravenous immunoglobulin by low pH incubation. J. Microbiol. Biotechnol. 2001, 11, 619-627.
48. Uemura, Y.; Yang, Y.H.; Heldebrant, C.M.; Takechi, K.; Yokoyama, K. Inactivation and elimination of viruses during preparation of human intravenous immunoglobulin. Vox Sang. 1994, 67, 246-254. [CrossRef] [PubMed]
49. Wang, J.; Mauser, A.; Chao, S.F.; Remington, K.; Treckmann, R.; Kaiser, K.; Pifat, D.; Hotta, J. Virus inactivation and protein recovery in a novel ultraviolet-C reactor. Vox Sang. 2004, 86, 230-238. [CrossRef] [PubMed]
50. Troccoli, N.M.; McIver, J.; Losikoff, A.; Poiley, J. Removal of viruses from human intravenous immune globulin by 35 nm nanofiltration. Biologicals 1998, 26, 321-329. [CrossRef] [PubMed]
51. Reichl, H.E.; Foster, P.R.; Welch, A.G.; Li, Q.; MacGregor, I.R.; Somerville, R.A.; Fernie, K.; Steele, P.J.; Taylor, D.M. Studies on the removal of a bovine spongiform encephalopathy-derived agent by processes used in the manufacture of human immunoglobulin. Vox Sang. 2002, 83, 137-145. [CrossRef] [PubMed]
52. Zolton, R.P.; Padvelskis, J.V.; Kaplan, P.M. Removal of hepatitis B virus infectivity from human gamma-globulin prepared by ion-exchange chromatography. Vox Sang. 1985, 49, 381-389. [CrossRef] [PubMed]
53. Biesert, L. Virus validation studies of immunoglobulin preparations. Clin. Exp. Rheumatol. 1996, 14, 47-52.
54. Rodewald, R.; Abrahamson, D.R. Receptor-mediated transport of IgG across the intestinal epithelium of the neonatal rat. Ciba Found. Symp. 1982, 209-232.
55. Morell, A.; Terry,W.D.; Waldmann, T.A. Metabolic properties of IgG subclasses in man. J. Clin. Investig. 1970, 49, 673-680. [CrossRef] [PubMed]
56. Wasserman, R.L.; Church, J.A.; Peter, H.H.; Sleasman, J.W.; Melamed, I.; Stein, M.R.; Bichler, J. Pharmacokinetics of a new 10% intravenous immunoglobulin in patients receiving replacement therapy for primary immunodeficiency. Eur. J. Pharm. Sci. 2009, 37, 272-278. [CrossRef] [PubMed]
57. Bonilla, F.A. Pharmacokinetics of immunoglobulin administered via intravenous or subcutaneous routes. Immunol. Allergy Clin. North Am. 2008, 28, 803-819. [CrossRef] [PubMed]
58. Brambell, F.W.R.; Hemmings, W.A.; Morris, I.G. A theorectical model of gammaglobulin catabolism. Nature 1964, 203, 1352-1355. [CrossRef] [PubMed]
59. Junghans, R.P.; Anderson, C.L. The protection receptor for IgG catabolism is the beta2-microglobulin-containing neonatal intestinal transport receptor. Proc. Natl. Acad. Sci. USA 1996, 93, 5512-5516. [CrossRef] [PubMed]
60. Victor, G.; Hubbard, J.G.; Kim, J.K.; Tsen, M.F.; Lee, Y.; Ward, E.S. Abnormally short seerum half-lives of IgG in beta-2 microglobulin-deficient mice. Eur. J. Immunol. 1996, 26, 690-696.
61. Koleba, T.; Ensom, M.H.H. Pharmacokinetics of intravenous immunoglobulin: A systematic review. Pharmacotherapy 2006, 26, 813-827. [CrossRef] [PubMed]
62. Gelfand, E.W. Intravenous immune globulin in autoimmune and inflammatory diseases. N. Engl. J. Med. 2012, 367, 2015-2025. [CrossRef] [PubMed]
63. Samuelsson, A.; Towers, T.L.; Ravetch, J.V. Anti-inflammatory activity of IVIG mediated through the inhibitory Fc receptor. Science 2001, 291, 484-486. [CrossRef] [PubMed]
64. Dwyer, J.M. Manipulating the immune system with immune globulin. N. Engl. J. Med. 1992, 326, 107-116. [PubMed]
65. Sultan, Y.; Kazatchkine, M.D.; Maisonneuve, P.; Nydegger, U.E. Anti-idiotypic suppression of autoantibodies to factor VIII (antihaemophilic factor) by high-dose intravenous gammaglobulin. Lancet 1984, 2, 765-768. [CrossRef]
66. Basta, M. Modulation of complement-mediated immune damage by intravenous immune globulin. Clin. Exp. Immunol. 1996, 104, 21-25. [PubMed]
67. Andersson, J.; Skansén-Saphir, U.; Sparrelid, E.; Andersson, U. Intravenous immune globulin affects cytokine production in T lymphocytes and monocytes/macrophages. Clin. Exp. Immunol. 1996, 104, 10-20. [PubMed]
68. Viard, I.;Wehrli, P.; Bullani, R.; Schneider, P.; Holler, N.; Salomon, D.; Hunziker, T.; Saurat, J.H.; Tschopp, J.; French, L.E. Inhibition of toxic epidermal necrolysis by blockade of CD95 with human intravenous immunoglobulin. Science 1998, 282, 490-493. [CrossRef] [PubMed]
69. Altznauer, F.; von Gunten, S.; Späth, P.; Simon, H.U. Concurrent presence of agonistic and antagonistic anti-CD95 autoantibodies in intravenous Ig preparations. J. Allergy Clin. Immunol. 2003, 112, 1185-1190. [CrossRef] [PubMed]
70. Bayry, J.; Carbonneil, C.; Misra, N.; Donkova, V.; Pashov, A.; Chevailler, A.; Mouthon, L.; Weill, B.; Bruneval, P.; Kazatchkine, M.D.; et al. Inhibition of maturation and function of dendritic cells by intravenous immunoglobulin. Blood 2003, 101, 758-765. [CrossRef] [PubMed]
71. Othy, S.; Bruneval, P.; Topçu, S.; Dugail, I.; Delers, F.; Lacroix-Desmazes, S.; Bayry, J.; Kaveri, S.V. Effect of IVIg on human dendritic cell-mediated antigen uptake and presentation: Role of lipid accumulation. J. Autoimmun. 2012, 39, 168-172. [CrossRef] [PubMed]
72. Spahn, J.D.; Leung, D.Y.; Chan, M.T.; Szefler, S.J.; Gelfand, E.W. Mechanisms of glucocorticoid reduction in asthmatic subjects treated with intravenous immunoglobulin. J. Allergy Clin. Immunol. 1999, 103, 421-426. [CrossRef]
73. Mausberg, A.K.; Dorok, M.; Stettner, M.; Müller, M.; Hartung, H.P.; Dehmel, T.; Warnke, C.; Zu Hörste, G.M.; Kieseier, B.C. Recovery of the T-cell repertoire in CIDP by IV immunoglobulins. Neurology 2013, 80, 296-303. [CrossRef] [PubMed]
74. Costa, N.; Pires, A.E.; Gabriel, A.M.; Goulart, L.F.; Pereira, C.; Leal, B.; Queiros, A.C.; Chaara, W.; Moraes-Fontes, M.F.; Vasconcelos, C.; et al. Broadened T-cell repertoire diversity in ivIg-treated SLE patients is also related to the individual status of regulatory T-cells. J. Clin. Immunol. 2013, 33, 349-360. [CrossRef] [PubMed]
75. Afonso, A.B.; Justo, L.N.; Queirós, A.C.; Fesel, C.; Cabral, M.S.; da Silva, M.G.; Porrata, L.; Markovic, S.; Pires, A.E.; João, C. Treatment with low doses of polyclonal immunoglobulin improves B cell function during immune reconstitution in a murine model. J. Clin. Immunol. 2013, 33, 407-419. [CrossRef] [PubMed]
76. João, C.; Ogle, B.M.; Geyer, S. Immunoglobulin promotes the diversity and the function of T cells. Eur. J. Immunol. 2006, 36, 1718-1728. [CrossRef] [PubMed]
77. João, C.; Ogle, B.M.; Gay-Rabinstein, C.; Platt, J.L.; Cascalho, M. B cell-dependent TCR diversification. J. Immunol. 2004, 172, 4709-4716. [CrossRef] [PubMed]
78. Pires, A.; Afonso, A.; Queirós, A.; Cabral, M.; Porrata, L.; Markovic, S.; Kaveri, S.; da Silva, M.; João, C. Treatment with polyclonal immunoglobulin during T-cell reconstitution promotes naive T-cell proliferation. J. Immunother. 2010, 33, 618-625. [CrossRef] [PubMed]
79. Cordonnier, C.; Chevret, S.; Legrand, M.; Rafi, H.; Dhédin, N.; Lehmann, B.; Bassompierre, F.; Gluckman, E. Should immunoglobulin therapy be used in allogeneic stem-cell transplantation? A randomized, double-blind, dose effect, placebo-controlled, multicenter trial. Ann. Intern. Med. 2003, 139, 8-18. [CrossRef] [PubMed]
80. Molica, S.; Musto, P.; Chiurazzi, F.; Specchia, G.; Brugiatelli, M.; Cicoira, L.; Levato, D.; Nobile, F.; Corotenuto, M.; Liso, V.; et al. Prophylaxis against infections with low-dose intravenous immunoglobulins (IVIG) in chronic lymphocytic leukemia. Results of a crossover study. Haematologica 1996, 81, 121-126. [PubMed]
81. Kress, H.G. Reduced incidence of postoperative infection after intravenous administration of an immunoglobulin A- and immunoglobulin M-enriched preparation in anergic patients undergoing cardiac surgery. Crit. Care Med. 1999, 27, 1281-1287. [CrossRef] [PubMed]
82. Björk, I.N.; Fesel, C.; Brissac, C.; Lundkvist, I. Prophylactic intravenous immunoglobulin treatment influences serum immunoglobulin M repertoire development after allogeneic bone marrow transplantation. Scand. J. Immunol. 1999, 50, 73-82. [CrossRef]
83. Sundblad, A.; Marcos, M.; Huetz, F.; Freitas, A.; Heusser, C.; Portnoï, D.; Coutinho, A. Normal serum immunoglobulins influence the numbers of bone marrow pre-B and B cells. Eur. J. Immunol. 1991, 21, 1155-1161. [CrossRef] [PubMed]
84. Dietrich, G.; Varela, F.J.; Hurez, V.; Bouanani, M.; Kazatchkine, M.D. Selection of the expressed B cell repertoire by infusion of normal immunoglobulin G in a patient with autoimmune thyroiditis. Eur. J. Immunol. 1993, 23, 2945-2950. [CrossRef] [PubMed]
85. Coutinho, A.; Kazatchkine, M.D.; Avrameas, S. Natural autoantibodies. Curr. Opin. Immunol. 1995, 7, 812-818. [CrossRef]
86. Lacroix-Desmazes, S.; Kaveri, S.V.; Mouthon, L.; Ayouba, A.; Malanchère, E.; Coutinho, A.; Kazatchkine, M.D. Self-reactive antibodies (natural autoantibodies) in healthy individuals. J. Immunol. Methods 1998, 216, 117-137. [CrossRef]
87. Carbone, J. Adverse reactions and pathogen safety of intravenous immunoglobulin. Curr. Drug Saf. 2007, 2, 9-18. [CrossRef] [PubMed]
88. Orange, J.S.; Hossny, E.M.; Weiler, C.R.; Ballow, M.; Berger, M.; Bonilla, F.A.; Buckley, R.; Chinen, J.; El-Gamal, Y.; Mazer, B.D.; et al. Use of intravenous immunoglobulin in human disease: A review of evidence by members of the Primary Immunodeficiency Committee of the American Academy of Allergy, Asthma and Immunology. J. Allergy Clin. Immunol. 2006, 117, 525-553. [CrossRef] [PubMed]
89. Ahrer, K.; Buchacher, A.; Iberer, G.; Josic, D.; Jungbauer, A. Analysis of aggregates of human immunoglobulin G using size-exclusion chromatography, static and dynamic light scattering. J. Chromatogr. A 2003, 1009, 89-96. [CrossRef]
90. Ahrer, K.; Buchacher, A.; Iberer, G.; Jungbauer, A. Effects of ultra-/diafiltration conditions on present aggregates in human immunoglobulin G preparations. J. Memb. Sci. 2006, 274, 108-115. [CrossRef]
91. Kaveri, S.V.; Maddur, M.S.; Hegde, P.; Lacroix-Desmazes, S.; Bayry, J. Intravenous immunoglobulins in immunodeficiencies: More than mere replacement therapy. Clin. Exp. Immunol. 2011, 164, 2-5. [CrossRef] [PubMed]
92. Kaveri, S. Advances in the treatment of primary and secondary immune deficiences. Curr. Opin. Allergy Clin. Immunol. 2013, 13, 51-52. [CrossRef] [PubMed]
93. Bonilla, F.A.; Bernstein, I.L.; Khan, D.; Ballas, Z.K.; Chinen, J.; Frank, M.M.; Kobrynski, L.J.; Levinson, A.I.; Mazer, B.; Nelson, R.P.; et al. Practice parameter for the diagnosis and management of primary immunodeficiency. Ann. Allergy. Asthma Immunol. 2005, 94, S1-S63. [CrossRef]
94. Litzman, J.; Jones, A.; Hann, I.; Chapel, H.; Strobel, S.; Morgan, G. Intravenous immunoglobulin, splenectomy, and antibiotic prophylaxis in Wiskott-Aldrich syndrome. Arch. Dis. Child. 1996, 75, 436-439. [CrossRef] [PubMed]
95. Conleya, M.E.; Saragoussib, D.; Notarangeloc, L.; Etzionid, A.; Casanova, J.-L. An international study examining therapeutic options used in treatment ofWiskott-Aldrich syndrome. Clin. Immunol. 2003, 109, 272-277. [CrossRef]
96. Maarschalk-Ellerbroek, L.; Hoepelman, I.; Ellerbroek, P. Immunoglobulin treatment in primary antibody deficiency. Int. J. Antimicrob. Agents 2011, 37, 396-404. [CrossRef] [PubMed]
97. Bernatowska-Matuszkiewicz, E.; Pac, M.; Skopcynska, H.; Pum, M.; Eibl, M.M. Clinical efficacy of intravenous immunoglobulin in patients with severe inflammatory chest disease and IgG3 subclass deficiency. Clin. Exp. Immunol. 1991, 85, 193-197. [CrossRef] [PubMed]
98. Imbach, P.; d'Apuzzo, V.; Hirt, A. High-dose intravenous gammaglobulin for idiopathic thrombocytopenic purpura in childhood. Lancet 1981, 1, 1228-1230. [CrossRef]
99. Godeau, B.; Lesage, S.; Divine, M.;Wirquin, V.; Farcet, J.P.; Bierling, P. Treatment of adult chronic autoimmune thrombocytopenic purpura with repeated high-dose intravenous immunoglobulin. Blood 1993, 82, 1415-1421. [PubMed]
100. Fujisawa, K.; Iyori, H.; Ohkawa, H.; Konishi, S.; Bessho, F.; Shirahata, A.; Miyazaki, S.; Akatsuka, J. A prospective, randomized trial of conventional, dose-accelerated corticosteroids and intravenous immunoglobulin in children with newly diagnosed idiopathic thrombocytopenic purpura. Int. J. Hematol. 2000, 72, 376-383. [PubMed]
101. Newburger, J.W.; Takahashi, M.; Burns, J.C.; Beiser, A.S.; Chung, K.J.; Duffy, C.E.; Glode, M.P.; Mason, W.H.; Reddy, V.; Sanders, S.P. The treatment of Kawasaki syndrome with intravenous gamma globulin. N. Engl. J. Med. 1986, 315, 341-347. [CrossRef] [PubMed]
102. Jibiki, T.; Terai, M.; Kurosaki, T.; Nakajima, H.; Suzuki, K.; Inomata, H.; Terashima, I.; Honda, T.; Yasukawa, K.; Hamada, H.; et al. Efficacy of intravenous immune globulin therapy combined with dexamethasone for the initial treatment of acute Kawasaki disease. Eur. J. Pediatr. 2004, 163, 229-233. [CrossRef] [PubMed]
103. Favre, O.; Leimgruber, A.; Nicole, A.; Spertini, F. Intravenous immunoglobulin replacement prevents severe and lower respiratory tract infections, but not upper respiratory tract and non-respiratory infections in common variable immune deficiency. Allergy 2005, 60, 385-390. [CrossRef] [PubMed]
104. Busse, P.J.; Razvi, S.; Cunningham-Rundles, C. Efficacy of intravenous immunoglobulin in the prevention of pneumonia in patients with common variable immunodeficiency. J Allergy Clin. Immunol. 2002, 109, 1001-1004. [CrossRef] [PubMed]
105. Raanani, P.; Gafter-Gvili, A.; Paul, M.; Ben-Bassat, I.; Leibovici, L.; Shpilberg, O. Immunoglobulin prophylaxis in chronic lymphocytic leukemia and multiple myeloma: Systematic review and meta-analysis. Leuk. Lymphoma 2009, 50, 764-772. [CrossRef] [PubMed]
106. Kiehl, M.G.; Müller, C. The optimum use of intravenous immunoglobulin for prophylaxis of opportunistic infection in HIV-infected adults. BioDrugs 1998, 10, 265-273. [CrossRef] [PubMed]
107. Abd-Allah, S.A.; Jansen, P.W.; Ashwal, S.; Perkin, R.M. Intravenous immunoglobulin as therapy for pediatric Guillain-Barre syndrome. J. Child Neurol. 1997, 12, 376-380. [CrossRef] [PubMed]
108. Hughes, R.A.C.; Swan, A.V.; van Doorn, P.A. Intravenous immunoglobulin for Guillain-Barré syndrome. Cochrane Database Syst. Rev. 2012. [CrossRef]
109. Gale, R.P.; Winston, D. Intravenous immunoglobulin in bone marrow transplantation. Cancer 1991, 68, 1451-1453. [CrossRef]
110. Sonneville, R.; Klein, I.F.; Wolff, M. Update on investigation and management of postinfectious encephalitis. Curr. Opin. Neurol. 2010, 23, 300-304. [CrossRef] [PubMed]
111. Murthy, S.N.K.; Faden, H.S.; Cohen, M.E.; Bakshi, R. Acute disseminated encephalomyelitis in children. Pediatrics 2002, 110, e21. [CrossRef] [PubMed]
112. Sahlas, D.J.; Miller, S.P.; Guerin, M.; Veilleux, M.; Francis, G. Treatment of acute disseminated encephalomyelitis with intravenous immunoglobulin. Neurology 2000, 54, 1370-1372. [CrossRef] [PubMed]
113. Marchioni, E.; Marinou-Aktipi, K.; Uggetti, C.; Bottanelli, M.; Pichiecchio, A.; Soragna, D.; Piccolo, G.; Imbesi, F.; Romani, A.; Ceroni, M. Effectiveness of intravenous immunoglobulin treatment in adult patients with steroid-resistant monophasic or recurrent acute disseminated encephalomyelitis. J. Neurol. 2002, 249, 100-104. [CrossRef] [PubMed]
114. Nishikawa, M.; Ichiyama, T.; Hayashi, T.; Ouchi, K.; Furukawa, S. Intravenous immunoglobulin therapy in acute disseminated encephalomyelitis. Pediatr. Neurol. 1999, 21, 583-586. [CrossRef]
115. Van Schaik, I.N.; Winer, J.B.; de Haan, R.; Vermeulen, M. Intravenous immunoglobulin for chronic inflammatory demyelinating polyradiculoneuropathy: A systematic review. Lancet Neurol. 2002, 1, 491-498. [CrossRef]
116. Eftimov, F.; Schaik, I. Chronic inflammatory demyelinating polyradiculoneuropathy: Update on clinical features, phenotypes and treatment options. Curr. Opin. Neurol. 2013, 26, 496-502. [CrossRef] [PubMed]
117. Wang, D.X.; Shu, X.M.; Tian, X.L.; Chen, F.; Zu, N.; Ma, L.; Wang, G.C. Intravenous immunoglobulin therapy in adult patients with polymyositis/dermatomyositis: A systematic literature review. Clin. Rheumatol. 2012, 31, 801-806. [CrossRef] [PubMed]
118. Dalakas, M.C.; Illa, I.; Dambrosia, J.M.; Soueidan, S.A.; Stein, D.P.; Otero, C.; Dinsmore, S.T.; McCrosky, S. A controlled trial of high-dose intravenous immune globulin infusions as treatment for dermatomyositis. N. Engl. J. Med. 1993, 329, 1993-2000. [CrossRef] [PubMed]
119. Cherin, P.; Herson, S.; Wechsler, B.; Piette, J.C.; Bletry, O.; Coutellier, A.; Ziza, J.M.; Godeau, P. Efficacy of intravenous gammaglobulin therapy in chronic refractory polymyositis and dermatomyositis: An open study with 20 adult patients. Am. J. Med. 1991, 91, 162-168. [CrossRef]
120. Cherin, P.; Pelletier, S.; Teixeira, A.; Laforet, P.; Genereau, T.; Simon, A.; Maisonobe, T.; Eymard, B.; Herson, S. Results and long-term followup of intravenous immunoglobulin infusions in chronic, refractory polymyositis: An open study with thirty-five adult patients. Arthritis Rheum. 2002, 46, 467-474. [CrossRef] [PubMed]
121. Cherin, P.; Piette, J.C.; Wechsler, B.; Bletry, O.; Ziza, J.M.; Laraki, R.; Godeau, P.; Herson, S. Intravenous gamma globulin as first line therapy in polymyositis and dermatomyositis: an open study in 11 adult patients. J. Rheumatol. 1994, 21, 1092-1097. [PubMed]
122. Dalakas, M.C.; Sonies, B.; Dambrosia, J.; Sekul, E.; Cupler, E.; Sivakumar, K. Treatment of inclusion-body myositis with IVIg: A double-blind, placebo-controlled study. Neurology 1997, 48, 712-716. [CrossRef] [PubMed]
123. Walter, M.C.; Lochmuller, H.; Toepfer, M.; Schlotter, B.; Reilich, P.; Schroder, M.; Muller-Felber, W.; Pongratz, D. High-dose immunoglobulin therapy in sporadic inclusion body myositis: A double-blind, placebo-controlled study. J. Neurol. 2000, 247, 22-28. [CrossRef] [PubMed]
124. Verschuuren, J.J.G.M.; Wirtz, P.W.; Titulaer, M.J.; Willems, L.N.; van Gerven, J. Available treatment options for the management of Lambert-Eaton myasthenic syndrome. Expert Opin. Pharmacother. 2006, 7, 1323-1336. [CrossRef] [PubMed]
125. Federico, P.; Zochodne, D.W.; Hahn, A.F.; Brown,W.F.; Feasby, T.E. Multifocal motor neuropathy improved by IVIg: Randomized, double-blind, placebo-controlled study. Neurology 2000, 55, 1256-1262. [CrossRef] [PubMed]
126. Filippini, G.; del Giovane, C.; Vacchi, L.; D'Amico, R.; di Pietrantonj, C.; Beecher, D.; Salanti, G. Immunomodulators and immunosuppressants for multiple sclerosis: A network meta-analysis. Cochrane Database Syst. Rev. 2013. [CrossRef]
127. Sorensen, P.S. Intravenous polyclonal human immunoglobulins in multiple sclerosis. Neurodegener. Dis. 2007, 5, 8-15. [CrossRef] [PubMed]
128. Gajdos, P.; Chevret, S.; Toyka, K.V. Intravenous immunoglobulin for myasthenia gravis. Cochrane Database Syst. Rev. 2012. [CrossRef]
129. Fergusson, D.; Hutton, B.; Sharma, M.; Tinmouth, A.; Wilson, K.; Cameron, D.W.; Hebert, P.C. Use of intravenous immunoglobulin for treatment of neurologic conditions: A systematic review. Transfusion 2005, 45, 1640-1657. [CrossRef] [PubMed]
130. Alessi, G.; de Reuck, J.; de Bleecker, J.; Vancayzeele, S. Successful immunoglobulin treatment in a patient with neuromyotonia. Clin. Neurol. Neurosurg. 2000, 102, 173-175. [CrossRef]
131. Van den Berg, J.S.P.; van Engelen, B.G.M.; Boerman, R.H.; de Baets, M.H. Acquired neuromyotonia: Superiority of plasma exchange over high-dose intravenous human immunoglobulin. J. Neurol. 1999, 246, 623-625. [CrossRef] [PubMed]
132. Levy, Y.; Uziel, Y.; Zandman, G.; Rotman, P.; Amital, H.; Sherer, Y.; Langevitz, P.; Goldman, B.; Shoenfeld, Y. Response of vasculitic peripheral neuropathy to intravenous immunoglobulin. Ann. NY Acad. Sci. USA 2005, 1051, 779-786. [CrossRef] [PubMed]
133. Kawagashira, Y.;Watanabe, H.; Oki, Y.; Iijima, M.; Koike, H.; Hattori, N.; Katsuno, M.; Tanaka, F.; Sobue, G. Intravenous immunoglobulin therapy in proximal diabetic neuropathy. BMJ Case Rep. 2009. [CrossRef] [PubMed]
134. Kawagashira, Y.;Watanabe, H.; Oki, Y.; Iijima, M.; Koike, H.; Hattori, N.; Katsuno, M.; Tanaka, F.; Sobue, G. Intravenous immunoglobulin therapy markedly ameliorates muscle weakness and severe pain in proximal diabetic neuropathy. J. Neurol. Neurosurg. Psychiatry 2007, 78, 899-901. [CrossRef] [PubMed]
135. Kawagashira, Y.; Watanabe, H.; Morozumi, S.; Iijima, M.; Koike, H.; Hattori, N.; Sobue, G. Differential response to intravenous immunoglobulin (IVIg) therapy among multifocal and polyneuropathy types of painful diabetic neuropathy. J. Clin. Neurosci. 2010, 17, 1003-1008. [CrossRef] [PubMed]
136. Uchuya, M.; Graus, F.; Vega, F.; Reñé, R.; Delattre, J.Y. Intravenous immunoglobulin treatment in paraneoplastic neurological syndromes with antineuronal autoantibodies. J. Neurol. Neurosurg. Psychiatry 1996, 60, 388-392. [CrossRef] [PubMed]
137. Grisold,W.; Giometto, B.; Vitaliani, R.; Oberndorfer, S. Current approaches to the treatment of paraneoplastic encephalitis. Ther. Adv. Neurol. Disord. 2011, 4, 237-248. [CrossRef] [PubMed]
138. Lopez-Sublet, M.; Bihan, H.; Reach, G.; Dupont, S.; Didelot, A.; Mourad, J.J.; Krivitzky, A.; Dhote, R. Limbic encephalitis and type 1 diabetes with glutamic acid decarboxylase 65 (GAD65) autoimmunity: Improvement with high-dose intravenous immunoglobulin therapy. Diabetes Metab. 2012, 38, 273-275. [CrossRef] [PubMed]
139. Phuphanich, S.; Brock, C. Neurologic improvement after high-dose intravenous immunoglobulin therapy in patients with paraneoplastic cerebellar degeneration associated with anti-purkinje cell antibody. J. Neurooncol. 2007, 81, 67-69. [CrossRef] [PubMed]
140. Levy, Y.; Uziel, Y.; Zandman, G.G.; Amital, H.; Sherer, Y.; Langevitz, P.; Goldman, B.; Shoenfeld, Y. Intravenous immunoglobulins in peripheral neuropathy associated with vasculitis. Ann. Rheum. Dis. 2003, 62, 1221-1223. [CrossRef] [PubMed]
141. Bataller, L.; Graus, F.; Saiz, A.; Vilchez, J.J. Clinical outcome in adult onset idiopathic or paraneoplastic opsoclonus-myoclonus. Brain 2001, 124, 437-443. [CrossRef] [PubMed]
142. Dalakas, M.; Quarles, R.; Farrer, R.; Dambrosia, J.; Soueidan, S.; Stein, D.; Cupler, E.; Sekul, E.; Otero, C. A controlled study of intravenous immunoglobulin in demyelinating neuropathy with IgM gammopathy. Ann. Neurol. 1996, 40, 792-795. [CrossRef] [PubMed]
143. Comi, G.; Roveri, L.; Swan, A.; Willison, H.; Bojar, M.; Illa, I.; Karageorgiou, C.; Nobile-Orazio, E.; van den Bergh, P.; Swan, T.; et al. A randomised controlled trial of intravenous immunoglobulin in IgM paraprotein associated demyelinating neuropathy. J. Neurol. 2002, 249, 1370-1377. [CrossRef] [PubMed]
144. Dalakas, M.C.; Fujii, M.; Li, M.; Lutfi, B.; Kyhos, J.; McElroy, B. High-dose intravenous immune globulin for stiff-person syndrome. N. Engl. J. Med. 2001, 345, 1870-1876. [CrossRef] [PubMed]
145. Mukhtyar, C.; Guillevin, L.; Cid, M.C.; Dasgupta, B.; de Groot, K.; Gross, W.; Hauser, T.; Hellmich, B.; Jayne, D.; Kallenberg, C.G.M.; et al. EULAR recommendations for the management of primary small and medium vessel vasculitis. Ann. Rheum. Dis. 2009, 68, 310-317. [CrossRef] [PubMed]
146. Becker, B.N.; Fuchs, H.; Hakim, R. Intravenous immune globulin in the treatment of patients with systemic lupus erythematosus and end-stage renal disease. J. Am. Soc. Nephrol. 1995, 5, 1746-1750. [PubMed]
147. Levy, Y.; Sherer, Y.; George, J.; Rovensky, J.; Lukac, J.; Rauova, L.; Poprac, P.; Langevitz, P.; Fabbrizzi, F.; Shoenfeld, Y. Intravenous immunoglobulin treatment of lupus nephritis. Semin. Arthritis Rheum. 2000, 29, 321-327. [CrossRef]
148. Sherer, Y.; Levy, Y.; Shoenfeld, Y. Intravenous immunoglobulin therapy of antiphospholipid syndrome. Rheumatology 2000, 39, 421-426. [CrossRef] [PubMed]
149. Konova, E. Intravenous immunoglobulin therapy in antiphospholipid syndrome. Clin. Rev. Allergy Immunol. 2005, 29, 229-236. [CrossRef]
150. Jayne, D.R.; Lockwood, C.M. Pooled intravenous immunoglobulin in the management of systemic vasculitis. Adv. Exp. Med. Biol. 1993, 336, 469-472. [PubMed]
151. Jayne, D.R.; Chapel, H.; Adu, D.; Misbah, S.; O'Donoghue, D.; Scott, D.; Lockwood, C.M. Intravenous immunoglobulin for ANCA-associated systemic vasculitis with persistent disease activity. QJM 2000, 93, 433-439. [CrossRef] [PubMed]
152. Jayne, D.R.; Lockwood, C.M. Intravenous immunoglobulin as sole therapy for systemic vasculitis. Br. J. Rheumatol. 1996, 35, 1150-1153. [CrossRef] [PubMed]
153. Richter, C.; Schnabel, A.; Csernok, E.; de Groot, K.; Reinhold-Keller, E.; Gross, W.L. Treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated systemic vasculitis with high-dose intravenous immunoglobulin. Clin. Exp. Immunol. 1995, 101, 2-7. [CrossRef] [PubMed]
154. Zandman-Goddard, G.; Levy, Y.; Shoenfeld, Y. Intravenous immunoglobulin therapy and systemic lupus erythematosus. Clin. Rev. Allergy Immunol. 2005, 29, 219-228. [CrossRef]
155. Waymack, J.P.; Jenkins, M.E.; Alexander, J.W.; Warden, G.D.; Miller, A.C.; Carey, M.; Ogle, C.K.; Kopcha, R.G. A prospective trial of prophylactic intravenous immune globulin for the prevention of infections in severely burned patients. Burns 1989, 15, 71-76. [CrossRef]
156. Braun-Moscovici, Y.; Furst, D.E. Immunoglobulin for rheumatic diseases in the twenty-first century: Take it or leave it? Curr. Opin. Rheumatol. 2003, 15, 237-245. [CrossRef] [PubMed]
157. Ogi, M.; Yokoyama, H.; Tomosugi, N.; Hisada, Y.; Ohta, S.; Takaeda, M.; Wada, T.; Naito, T.; Ikeda, K.; Goshima, S. Risk factors for infection and immunoglobulin replacement therapy in adult nephrotic syndrome. Am. J. Kidney Dis. 1994, 24, 427-436. [CrossRef]
158. Alejandria, M.M.; Lansang, M.A.; Dans, L.F.; Mantaring, J.B. Intravenous immunoglobulin for treating sepsis and septic shock. Cochrane Database Syst. Rev. 2013. [CrossRef]
159. Werdan, K. Intravenous immunoglobulin for prophylaxis and therapy of sepsis. Curr. Opin. Crit. Care 2001, 7, 354-361. [CrossRef] [PubMed]
160. Laupland, K.B.; Kirkpatrick, A.W.; Delaney, A. Polyclonal intravenous immunoglobulin for the treatment of severe sepsis and septic shock in critically ill adults: A systematic review and meta-analysis. Crit. Care Med. 2007, 35, 2686-2692. [CrossRef] [PubMed]
161. Turgeon, A.F.; Hutton, B.; Fergusson, D.A.; McIntyre, L.; Tinmouth, A.A.; Cameron, D.W.; Hébert, P.C. Meta-analysis: Intravenous immunoglobulin in critically ill adult patients with sepsis. Ann. Intern. Med. 2007, 146, 193-203. [CrossRef] [PubMed]
162. Darenberg, J.; Ihendyane, N.; Sjolin, J.; Aufwerber, E.; Haidl, S.; Follin, P.; Andersson, J.; Norrby-Teglund, A.; Group, T.S.S. Intravenous immunoglobulin G therapy in streptococcal toxic shock syndrome: A European Randomized, Double-Blind, Placebo-Controlled Trial. Clin. Infect. Dis. 2003, 37, 333-340. [CrossRef] [PubMed]
163. McPherson, S.; Rees, C.J.; Ellis, R.; Soo, S.; Panter, S.J. Intravenous immunoglobulin for the treatment of severe, refractory, and recurrent Clostridium difficile diarrhea. Dis. Colon Rectum 2006, 49, 640-645. [CrossRef] [PubMed]
164. Wilcox, M.H. Descriptive study of intravenous immunoglobulin for the treatment of recurrent Clostridium difficile diarrhoea. J. Antimicrob. Chemother. 2004, 53, 882-884. [CrossRef] [PubMed]