Pentaglobin in steroid-resistant severe acute respiratory syndrome.
METHODS
The treatment of severe acute respiratory syndrome (SARS) is at best controversial, although there is considerable anecdotal experience to show the benefits of corticosteroid therapy for selected patients. Some patients deteriorate relentlessly despite treatment with antibiotic, corticosteroid and mechanical ventilation.


OBJECTIVE
To attempt to determine the clinical efficacy of pentaglobin, an IgM-enriched immunoglobulin preparation, on 12 severe SARS patients who continued to deteriorate despite corticosteroid and ribavirin therapy.


METHODS
Retrospective analysis of daily quantitative and radiographic data on the cohort in a regional teaching hospital.


CONCLUSIONS
There was significant improvement in radiographic scores, when compared with day 1, on days 5, 6 and 7 (P < 0.05) after commencement of pentaglobin treatment. Similarly, there was significant improvement in oxygen requirement, when compared with day 1, on days 6 and 7 (P < 0.05) after commencement of pentaglobin treatment. There were no reported adverse events attributable to pentaglobin administration. Ten patients made an uneventful recovery after treatment. One elderly man died from cardiorespiratory arrest despite clinical and radiological improvement, and another patient is making good progress. Pentaglobin is safe and probably effective in the treatment of steroid-resistant SARS. A double-blind placebo-controlled study should therefore be considered.
Ho
J C
JC
Department of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Wu
A Y
AY
Lam
B
B
Ooi
G C
GC
Khong
P L
PL
Ho
P L
PL
Chan-Yeung
M
M
Zhong
N S
NS
Ko
C
C
Lam
W K
WK
Tsang
K W
KW
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000008:administration & dosage / Q000627:therapeutic use*; D007075:Immunoglobulin M / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use; D045169:Severe Acute Respiratory Syndrome / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D007070:Immunoglobulin A; D007075:Immunoglobulin M; D012254:Ribavirin; C060166:pentaglobulin