Journal article
Intravenous immunoglobulin in drug and device refractory patients with the symptoms of gastroparesisan open-label study
Neurogastroenterology and motility, Vol.30(3), e13256
03/01/2018
DOI: 10.1111/nmo.13256
PMID: 29205691
Abstract
Background Gastroparesis is a complex clinical entity; many aspects of which remain unknown. Although most patients have idiopathic, diabetic, or postsurgical gastroparesis, many are thought to have measurable neuromuscular abnormalities. Immunotherapy has recently been utilized to treat suspected autoimmune gastrointestinal dysmotility.
Methods Fourteen patients with symptoms of gastroparesis (Gp) who were refractory to drug/device were selected from 443Gp patients from 2013 to 2015 who were treated at the University of Louisville motility center. All patients underwent a structural and psychiatric evaluation along with detailed psychological and behavioral examination to rule out eating disorders. We performed detailed neuromuscular evaluation and all 14 patients received at least 12weeks of intravenous immunoglobulin (400mg/kg infusion weekly). Response was defined subjectively (symptomatic improvement) using standardized IDIOM score system.
Key Results All 14 patients had serological evidence and/or tissue evidence of immunological abnormality. Post-IVIG therapy, there was a significant improvement in symptoms scores for nausea, vomiting, early satiety, and abdominal pain.
Conclusions and Inferences Although limited by the absence of placebo group, the data illustrate the role of autoimmunity and neuromuscular evaluation in patients with gastroparesis and support the utility of a diagnostic trial of immunotherapy in an effort to improve therapeutic outcomes for such patients.
Details
- Title: Subtitle
- Intravenous immunoglobulin in drug and device refractory patients with the symptoms of gastroparesisan open-label study
- Creators
- M. Ashat - University of IowaA. Lewis - University of LouisvilleH. Liaquat - University of LouisvilleA. Stocker - University of LouisvilleL. McElmurray - University of LouisvilleV. Vedanarayanan - University of MississippiK. Soota - University of IowaT. Howell - Jewish HospitalA. Kedar - University of Mississippi Medical CenterJ. Obert - University of LouisvilleT. L. Abell - Motility
- Resource Type
- Journal article
- Publication Details
- Neurogastroenterology and motility, Vol.30(3), e13256
- Publisher
- Wiley
- DOI
- 10.1111/nmo.13256
- PMID
- 29205691
- ISSN
- 1350-1925
- eISSN
- 1365-2982
- Number of pages
- 10
- Language
- English
- Date published
- 03/01/2018
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984359834102771
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