Features of high-dose intravenous immunotherapy administration in patients with reduced IgA level in neurological practice: literature review and description of a clinical case

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Abstract

Intravenous high-dose immunotherapy is one of the highly effective proven treatments for a number of autoimmune diseases of the nervous system. Nowadays there is enough knowledge about the spectrum of side effects and approaches to their prevention and monitoring. Most of them are leveled by improving the technology of the production process, but anaphylactic reactions remain one of the uncontrolled, albeit rare, undesirable reactions. The development of allergic reactions is associated with the presence of antibodies to immunoglobulin class A (IgA) in the patient, which is manifested by a decrease in the level of IgA during routine immunological examination. The article provides a review of the literature on the prevalence of IgA deficiency, its causes. A modern view of the need for routine testing of IgA level before the course of intravenous immunotherapy, approaches to reduce the risk of developing serious adverse reactions in such cases is described. A clinical case of treatment of a patient with chronic inflammatory demyelinating polyneuropathy and a reduced level of IgA is presented.

About the authors

A. S. Rizvanova

Research Center of Neurology.

Author for correspondence.
Email: rizvanova.alina@gmail.com
ORCID iD: 0000-0002-9890-3552
80 Volokolamskoe Shosse, Моscow 125367. Russian Federation

N. V. Belova

Research Center of Neurology.

Email: fake@neicon.ru
ORCID iD: 0000-0003-0792-5332
80 Volokolamskoe Shosse, Моscow 125367. Russian Federation

A. A. Raskurazhev

Research Center of Neurology.

Email: fake@neicon.ru
ORCID iD: 0000-0003-0522-767X
80 Volokolamskoe Shosse, Моscow 125367. Russian Federation

D. A. Grishina

Research Center of Neurology.

Email: fake@neicon.ru
ORCID iD: 0000-0002-7924-3405
80 Volokolamskoe Shosse, Моscow 125367. Russian Federation

N. I. Litvinov

Clinical Hospital No. 1, Administration of the President of the Russian Federation (Volynskaya).

Email: fake@neicon.ru
ORCID iD: 0000-0003-4220-8208
10 Starovolynskaya St., Moscow 121352. Russian Federation

D. E. Kutepov

Clinical Hospital No. 1, Administration of the President of the Russian Federation (Volynskaya).

Email: fake@neicon.ru
ORCID iD: 0000-0001-7236-6288
10 Starovolynskaya St., Moscow 121352. Russian Federation

Yu. V. Ryabinkina

Clinical Hospital No. 1, Administration of the President of the Russian Federation (Volynskaya).

Email: fake@neicon.ru
ORCID iD: 0000-0001-8576-9983
10 Starovolynskaya St., Moscow 121352. Russian Federation

T. V. Latysheva

Institute of Immunology, Federal Medical-Biological Agency of Russia.

Email: fake@neicon.ru
ORCID iD: 0000-0001-5880-8174
24 Kashirskoe Shosse, Moscow 115478. Russian Federation

N. A. Suponeva

Research Center of Neurology.

Email: fake@neicon.ru
ORCID iD: 0000-0003-3956-6362
80 Volokolamskoe Shosse, Моscow 125367. Russian Federation

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Copyright (c) 2018 Rizvanova A.S., Belova N.V., Raskurazhev A.A., Grishina D.A., Litvinov N.I., Kutepov D.E., Ryabinkina Y.V., Latysheva T.V., Suponeva N.A.

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