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Immune Globulin

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Ranking : Insufficient/Mixed evidenceVery Hazardous

Type(s) : Diets and supplements

Other Names :

  • Immunoglobulin
  • IVIG

Introduction

Some people believe that people with autistic spectrum disorders are susceptible to immune deficiencies and that these deficiencies may produce some of the symptoms of autism.

By injecting or swallowing immune globulin, an antibody used by the immune system to identify and neutralize foreign objects like bacteria and viruses, it is believed those abnormalities can be overcome and the symptoms of autism reduced.

Opinion

There is strong evidence that immune globulin is ineffective in the treatment of the majority of people with autistic spectrum disorders.

It is also expensive, inconvenient to use, and potentially harmful.

It is strongly recommended that immune globulin therapy is not used as a treatment for autism in children because of the substantial risks and the lack of proven benefit associated with this intervention.

If it is used, it should only be undertaken with great caution and only as part of formal research studies.

Disclaimer

Please read our Disclaimer about this intervention.

Audience

The supporters of Immune globulin state that it may be used for anyone with an autistic spectrum disorder – including autism and Asperger syndrome – unless it is contra-indicated.

Applicable Age Ranges

All ages

Aims

The proponents for the use of immune globulin claim that it can be used to rectify problems with the immune system, thereby overcoming some of the symptoms of autism.

Claims

There have been a number of claims for the treatment.

  • Gupta claimed that IVIG treatment resulted in improved eye contact, speech, behaviour, echolalia, and other autistic features.
  • Schneider claimed that IVIG treatment led to improvements in GI signs and symptoms, as well as significant behavioural improvements.

Detail

The most popular treatment is intravenous immunoglobulin G, given in varying protocols. The most aggressive protocol gives the immunoglobulin approximately every other day, in progressively increasing dosages, starting at 1 gm/kg, and increasing to 5 gm/kg. The more conservative protocol begins with 1 gm/kg, increasing to 2-7 gm/kg at monthly doses. An intermediate intensity protocol is 5 gm/kg, administered monthly. (Mehl-Madrona, 2000)

Time

The amount of time required depends on how often the immune globulin is used. This can be as much as once every other day or as little as once every month.

Involvement

The amount of involvement required depends on how often the immune globulin is used. This can be as much as once every other day or as little as once every month.

Costs

In the UK, IVIG (Vigam) costs £28.70 per gram and is available in 2.5g, 5g and 10g units.

If the intermediate protocol is used i.e. 5g/kg administered monthly

A 20kg child would need:

  • 100g / month = £2,870
  • 600g / 6 months = £1,7220

A 35kg child would need:

  • 175g / month = £5,022.50
  • 1050g / 6 months = £30,135

Credentials

Immune globulin should only be given by a qualified medical practitioner.

Availability

Immune globulin is available from qualified medical practitioners. However it is not available from the NHS in the UK as a treatment for autism.

Hazards

IVIg treatment is usually well tolerated. Most adverse effects are mild and are usually related to the rate of infusion. However, according to MedlinePlus, IVIG can cause a number of significant, life-threatening hazards.

  • It can cause kidney failure, especially in those with a history of kidney disease, diabetes, sepsis, plasma cell disease, or volume depletion, or in those taking medications that can cause kidney damage
  • It carries the risk of potentially fatal transmission of blood-borne pathogens. Pharmaceutical grade immune globulin is prepared commercially by separating immunoglobulin fractions from pooled human blood specimens. Several steps in the process are added to ensure that any live viruses or bacteria in the specimens are inactive – but there is still a risk.

It can also cause the following, serious side-effects which should be reported to a doctor immediately.

  • hives
  • chest tightness
  • dizziness
  • unusual tiredness or weakness
  • chills
  • fever
  • sweating
  • redness of the face
  • upset stomach
  • vomiting

For a full list of potential side effects, please see US National Library of Medicine. (2003). Immune Globulin Intravenous Injection. Bethesda, MD: US National Library of Medicine. Read Full item

Some of the people who have used IVIG on people with autism have noted increased thirst, drowsiness, sleep disturbance, sadness, dizziness, irritability, appetite change, and decreased activity.

Contraindications

Immune globulin is contraindicated for anyone with a history of kidney disease, diabetes, sepsis, plasma cell disease, or volume depletion, or in those taking medications that can cause kidney damage.

History

We have yet to identify by whom and when the use of immune globulin for people with autistic spectrum disorders was first suggested but we think it is likely to have been in the late 1980s.

Accounts

We have yet to identify any personal accounts – whether positive, negative or mixed – of individuals with autistic spectrum disorders using immune globulin.

Research

We have identified six scientific trials of immune globulin used on people with autistic spectrum disorders published in peer-reviewed journals

These trials included almost 2000 individuals aged 2-17.

  • 1 study (Gupta, 1996) reported significant improvements in one or more areas.
  • 2 studies (DelGiudice-Asch G,1999; Handen et al, in press) reported no effects.
  • 3 studies (Niederhofer, 2003; Plioplys, 1998; Schneider, 2006) reported limited or mixed results.

Status

There are problems with some of the research studies identified to date.

For example

  • Only two studies (Handen et al, (In press); and Niederhofer, Staffen and Mair, 2003) used a double blind crossover design. The latter has doubtful statistical difference of outcome
  • The other studies are open label, no placebo design, with mixed results. Most had non responders or a single responder.

The basis of treatment using immune globulin from a theoretical viewpoint is also very debatable as the existing research is based on small numbers and has not been replicated. In addition it is not at all certain there is anything wrong with general immunological status at all in people with autistic spectrum disorders.

Trials

Future

At this stage research into the use of immune globulin as an intervention for people with autistic spectrum disorders is not a priority.

If any future research does take place, it would be sensible to concentrate on replicating the gut study (Schneider et al., 2006).

Summary

There is strong evidence that immune globulin is ineffective in the treatment of the majority of people with autistic spectrum disorders.

Reading

  • Enstrom A. et al. (Epub ahead of print). Increased IgG4 levels in children with autism disorder. Brain, Behavior, and Immunity Read Abstract
  • Gupta S. (2000). Immunological treatments for autism. J Autism Dev Disord, 30(5), pp. 475-9. Read Abstract
  • Gupta S. (1999). Treatment of children with autism with intravenous immunoglobulin. J Child Neurol. 14(3), pp. 203-205. Read Abstract
  • Heuer L. et al. (2008). Reduced levels of immunoglobulin in children with autism correlates with behavioral symptoms. Autism Research. pp. 275-283. Read Abstract
  • Mehl-Madrona, L. (2000). Effective Therapies for Autism and other Developmental Disorders. Autism/Asperger’s Digest Magazine. Read Full item
  • Plioplys A. V. (1999). Response to a letter by Dr Gupta concerning the treatment of autistic children with intravenous immunoglobulin. Journal of Child Neurology, 14 (3), pp. 203-205. Read Full item (PDF document).
  • [Rimland, B]. (1999). PANDAS treatment reduces symptoms. Autism Research Review International, 13 (3), p 7.
  • US National Library of Medicine. (2003). Immune Globulin Intravenous Injection. Bethseda, MD: US National Librarry of Medicine. Read Full item

More Information

The proponents of IVIG as a treatment for autism have not proposed a specific theory to explain why this treatment might be effective. Instead, IVIG has been proposed as both a replacement therapy for individuals with immune deficiency states and as a way to modulate the immune system (immunomodulary therapy) as a treatment for auto-immune and inflammatory diseases.

Not to be confused with Intravenous Gamma Globulin (IVIgG), which is also sometimes used to treat autistic spectrum disorders.

Issues

CommunicationDiet and NutritionGastro-Intestinal ProblemsImpaired ImmunityIrritabilityRestricted and Repetitive BehavioursSensory SensitivitySocial Skills

Keywords

Blood Globulin Human IGIV IgIV Immune Immuno Immunoglobulin Intravenous IVIG Plasma Therapy

Brand names include

BayGam® Carimune® NF Flebogamma® Gamimune® Gammagard® S/D Gammar® Gamunex® Iveegam® Octagam® Panglobulin® Polygam® Venoglobulin®

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Last Updated : 16/04/2010   Back to Top

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