IVIg TREATMENT OF PEMPHIGUS: How it Works and How to Use it.

The article presents information on the utility of intravenous immunoglobulin (IVIg) in the treatment of pemphigus. Contrary to the uncertain mechanism of action of IVIg in most autoimmune diseases, in pemphigus it seems to work by rapidly, dramatically, and selectively lowering serum levels of pemphigus antibodies. The mechanism of action of IVIg is very similar to that of plasmapheresis. Both procedures rapidly remove circulating pemphigus antibodies from the circulation and do so at about equal rates. However, IVIg has the major advantages over plasmapheresis that the pemphigus antibodies are removed selectively, whereas plasmapheresis as usually performed removes all circulating immunoglobulins, the good with the bad. Furthermore, IVIg appears to be safer.