title: Immunoglobulin responsive chronic pain.
abstract: BACKGROUND
  Over the last 15 years, clinical and experimental data have emerged that suggest that peripheral and central, glial-mediated neuroimmune activation is both necessary and sufficient to sustain chronic pain. Immune modulation appears to be, therefore, a possible new therapeutic option.
  
  
  METHODS
  The Medline database and international trial registry databases were searched using the keywords "intravenous immunoglobulin" or "IVIG," "pain" or "chronic pain," "neuropathic pain," "CRPS," "complex regional pain syndrome" or "fibromyalgia."
  
  
  RESULTS
  Evidence from RCTs suggest that IVIG is effective to reduce pain in complex regional pain syndrome (low-dose IVIG) and post-polio syndrome (high-dose IVIG), and open trials have suggested efficacy in additional pain conditions.
  
  
  CONCLUSIONS
  IVIG therapy may emerge as a novel treatment modality for refractory cases. However, before this drug can be confidently used by clinicians, important questions need to be answered concerning optimal treatment doses, duration of treatment, and its effect on function and quality of life.
authors.affiliation: Pain Research Institute, 3rd Floor, Clinical Sciences Centre, Liverpool University, Liverpool, UK. andreasgoebel@rocketmail.com
authors.forename: Andreas
authors.initials: A
authors.lastname: Goebel
mesh_terms: D002908:Chronic Disease; D020918:Complex Regional Pain Syndromes / Q000628:therapy; D016207:Cytokines / Q000378:metabolism; D005356:Fibromyalgia / Q000628:therapy; D006801:Humans; D006930:Hyperalgesia / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D008407:Mast Cells / Q000378:metabolism; D018448:Models, Immunological; D008959:Models, Neurological; D009437:Neuralgia / Q000628:therapy; D009457:Neuroglia / Q000378:metabolism; D009619:Nociceptors / Q000502:physiology; D010146:Pain / Q000503:physiopathology; D059408:Pain Management; D020671:Posterior Horn Cells / Q000503:physiopathology; D016262:Postpoliomyelitis Syndrome / Q000628:therapy; D016032:Randomized Controlled Trials as Topic; D011984:Sensory Receptor Cells / Q000502:physiology; D013116:Spinal Cord / Q000503:physiopathology
chemical_list: D016207:Cytokines; D016756:Immunoglobulins, Intravenous