• J. Clin. Immunol. · May 2010

    Review

    Immunoglobulin responsive chronic pain.

    • Andreas Goebel.
    • Pain Research Institute, 3rd Floor, Clinical Sciences Centre, Liverpool University, Liverpool, UK. andreasgoebel@rocketmail.com
    • J. Clin. Immunol. 2010 May 1; 30 Suppl 1: S103-8.

    IntroductionOver 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.Materials And MethodsThe 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."ResultsEvidence 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.ConclusionIVIG 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.

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