[Value of intravenous immunoglobulins during antiphospholipid syndrome].
BACKGROUND
The antiphospholipid syndrome was individualized 12 years ago. Treatment was initially based on steroids, immunosuppressive drugs and intravenous immunoglobulin therapy. More recently, several retrospective studies have established that in most clinical conditions therapeutic doses of oral vitamin K antagonists (INR > or = 3) are sufficient to control the disease.
However, high dose immunoglobulin therapy is still indicated in a few cases, especially in life-threatening immune peripheral thrombocytopenia, and in recurrent foetal loss: in the latter indication, immunoglobulin therapy alone is efficient in 80% of cases.


CONCLUSIONS
Prospective studies are needed to assess the efficacy of intravenous immunoglobulin therapy in neurological complications occurring in spite of anticoagulant therapy, and in the context of repeated foetal losses when antithrombotic therapy with aspirin and subcutaneous heparin has failed.
Blétry
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Service de médecine interne, Hôpital Foch, Suresnes, France.
Blanc
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Piette
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D000925:Anticoagulants / Q000627:therapeutic use; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000276:immunology / Q000628:therapy*; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D018579:Patient Selection; D011446:Prospective Studies; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000209:etiology; D013927:Thrombosis / Q000209:etiology; D016896:Treatment Outcome; D014812:Vitamin K / Q000037:antagonists & inhibitors
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D016756:Immunoglobulins, Intravenous; D014812:Vitamin K