Abstract
Immunoglobulin (Ig) preparations are widely used as adjunctive sepsis therapies. The rationale for this treatment concept is the hypothesis that low endogenous serum levels of IgG, IgM or IgA may dispose to severe infection and sepsis, and that substitution with the respective immunoglobulins — either one of the many intravenous IgG preparations or the intravenous IgGMA preparation, Pentaglobin®, might improve prognosis. The following article offers an overview on adjunctive immunoglobulin therapy in adult patients with severe sepsis. For prophylaxis of sepsis in adults see [1], for prophylaxis and therapy of sepsis in neonates and infants see [1, 2].
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Werdan K (2001) Intravenous immunoglobulin therapy for prophylaxis and therapy of sepsis. Curr Opin Crit Care 7: 354–361
Kreymann KG, de Heer G, Nierhaus A, Kluge S (2007) Use of polyclonal immunoglobulins as adjunctive therapy for sepsis or septic shock. Crit Care Med 35: 2677–2685
German Federal Physicians’ Chamber based on recommendations of its scientific council: [Guidelines on therapy with blood components and plasma derivatives: Chapter 9: Human Immunoglobulins.] Deutscher Ärzteverlag, Köln, 2009: 195–220
Werdan K, Pilz G, Bujdoso O, et al, for the Score-Based Immunoglobulin Therapy of Sepsis (SBITS) Study Group (2007) Score-based immunoglobulin G therapy of patients with sepsis: The SBITS study. Crit Care Med 35: 2693–2701
Dietz S, Lautenschläger C, Mueller-Werdan U, Werdan K (2010) Low levels of immunoglobulin G in patients with sepsis or septic shock: a signum mali ominis? Crit Care 14 (Suppl1): P26
Dietz S, Päsler M, Köhler N, et al (2011) [Is a low serum level of immunoglobulin a preditor of increased mortality in sepsis and septic shock?] Intensivmed 48: 351 (P12)
Taccone FS, Stordeur P, de Backer D, Creteur J, Vincent JL (2009) ψ-Globulin levels in patients with community-acquired septic shock. Shock 32: 379–385
Pilz G, Appel R, Kreuzer E, Werdan K (1997) Comparison of early IgM enriched immunoglobulin vs polyvalent IgG administration in score-identified post-cardiac surgical patients at high risk for sepsis. Chest 111: 419–426
Esen F & Tugrul S (2009) IgM-enriched immunoglobulins in sepsis. In: Vincent J-L (ed) 2009 Yearbook of Intensive Care and Emergency Medicine. Springer, Heidelberg, pp 102–110
Werdan K (2007) Mirror, mirror on the wall, which is the fairest meta-analysis of all? Crit Care Med 35: 2852–2854
Werdan K, Pilz G, Mueller-Werdan U, et al, for the Early Supplemental Severe SIRS Treatment With IVIG In Score-identified High-risk Patients After Cardiac Surgery (ESSICS) Study Group (2008) Immunoglobulin G treatment of postcardiac surgery patients with score-identified severe systemic inflammatory response syndrome — the ESSICS Study. Crit Care Med 36: 716–723
Kazatchkine MD, Kaveri SV (2001) Immunomodulation of autoimmune and inflammatory diseases with intravenous immune globulin. N Engl J Med 345: 747–755
Vassilev T, Mihaylova N, Voynova E, Nikolova M, Kazatchkine M, Kaveri S (2006) IgMenriched human intravenous immunoglobulin suppresses T lymphocyte function in vitro and delays the activation of T lymphocytes in hu-SCID mice. Clin Exp Immunol 145: 108–115
Trautmann M, Held TK, Susa M, et al (1998) Bacterial lipopolysaccharide (LPS) specific antibodies in commercial human immunoglobulin preparations: superior antibody content of an IgM-enriched product. Clin Exp Immunol 111: 81–90
Rieben R, Muizert Y, Gerritsen AF, Daha MR (1999) Immunoglobulin M enriched human intravenous immunoglobulin prevents complement activation in vitro and in vivo in a rat model of acute inflammation. Blood 93: 942–951
Hoffmann JN, Fertmann JM, Vollmar B, Laschke MW, Jauch KW, Menger MD (2008) Immunoglobulin M-enriched human immunoglobulins reduce leucocyte-endothelial interactions and attenuate microvascular perfusion failure in normotensive endotoxemia. Shock 29: 133–139
Mohr M, Englisch L, Roth A, Burchardi H, Zielmann S (1997) Effects of early treatment with immunoglobulin on critical illness polyneuropathy following multiple organ failure and gram-negative sepsis. Intensive Care Med 23: 1144–1149
Schedel I, Dreikhausen U, Nentwig B, et al (1991) Treatment of Gram-negative septic shock with an immunoglobulin preparation: A prospective, randomized clinical trial. Crit Care Med 19: 1104–1113
Reinhart K, Brunkhorst FM, Bone H-G, et al (2010) Prävention, Diagnose, Therapie und Nachsorge der Sepsis. 1. Revision der S-2k Leitlinien der Deutschen Sepsis-Gesellschaft e.V. (DSG) und der Deutschen Interdisziplinären Vereinigung für Intensiv-und Notfallmedizin (DIVI) Intensiv-und Notfallbehandlung 35: 56–104
Dellinger PR, Carlet JM, Masur H, et al, for the International Surviving Sepsis Campaign Guideline Committee (2008) Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med 36: 296–327
Thomson A, Sills J, Hart CA, Harris F (1989) Anti-endotoxin therapy for fulminant meningococcal septicaemia: pilot study. Arch Dis Child 64: 1217–1218
Kaul et McGeer A, Norrby-Teglund A, et al, and the Canadian Streptococcal Study Group (1999) Intravenous immunoglobulin therapy for streptococcal toxic shock syndrome — a comparative observational study. Clin Infect Dis 28: 800–807
Darenberg J, Ihendyane N, Sjölin J, et al, and the StreptIg Study Group (2003) Intravenous immunoglobulin G therapy in streptococcal toxic shock syndrome: a european randomized, double-blind, placebo-controlled trial. Clin Infect Dis 37: 333–340
Werdan K (2006) Immunoglobulin treatment in sepsis — is the answer “no”? Crit Care Med 34: 1542–1544
Hentrich M, Fehnle K, Ostermann H, et al (2006) IgMA-enriched immunoglobulin in neutropenic patients with sepsis syndrome and septic shock: a randomized, controlled multicenter trial. Crit Care Med 34: 1319–1325
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Päsler, M., Dietz, S., Werdan, K. (2012). Hypogammaglobulinemia in Sepsis. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2012. Annual Update in Intensive Care and Emergency Medicine, vol 2012. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-25716-2_10
Download citation
DOI: https://doi.org/10.1007/978-3-642-25716-2_10
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-25715-5
Online ISBN: 978-3-642-25716-2
eBook Packages: MedicineMedicine (R0)