Introduction
Intravenous immunoglobulin preparations (IVIGs) have been used for many years in the treatment of many diseases. It finds itself a place within multiple indications especially due to its effects on the immune system. The first-use purpose of IVIGs, which was first used in the United States in 1981 with the approval of the FDA, was replacement therapy and has been used in different indications with the detection of anti-inflammatory and immunomodulatory effects over time.
The mechanism of action lies in binding with the Fc receptors of the phagocytic system or preventing the immunocomplexes from binding with these Fc receptors. In this way, proinflammatory mediator and cytokine release of macrophages are prevented. It is known to have regulatory effects not only on the mononuclear system, but also on T and B cells. The main effect on the B cell occurs with using different mechanisms. It suppresses antibody release of B cells, neutralizes auto-antibodies that play a role in many diseases. It inhibits B cell proliferation and accelerates the catabolism of pathological immune complexes.
It has also been found to have effects on T cells that inhibit proliferation and activation. In addition, dendritic cells, which are known to have a very strong effect on antigen presentation, are inhibited through the use in especially higher doses.
It inhibits the release of many proinflammatory cytokines such as IL-4, IL-5 and TNF-alpha. It prevents complement system activation with C3b and C4b inhibition.
With the emergence of these inflammatory effects, IVIGs, which are included in many indications, are also preferred in patients with hematologic benign or malignant diagnoses at different doses and usage frequencies. Although it is seen that the most common indication in the literature and daily practice is immune thrombocytopenic purpura and its emergency treatment, it is obvious that the frequency of use in different situations is increasing. In our study, we analyzed the use of IVIGs in our clinic retrospectively and obtained descriptive data.