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Prior reports, mostly from one physician in Boston, have suggested that high-dose immunoglobulin might be effective in patients with pemphigus resistant to traditional therapies. Previous observations have all been made in open-label studies.
In a multicenter Japanese study, these authors examined the effects of single cycles of intravenous immunoglobulin (IVIG; 400 mg/kg/day or 200 mg/kg/day) or placebo given for 5 consecutive days to 61 patients with pemphigus unresponsive to prednisolone. Response was assessed by the time it took a patient to escape from the protocol (i.e., time until patient required additional treatment). This unique assessment method has not been validated as a reliable scoring tool. The patients had pemphigus vulgaris…