Intravenous Immunoglobulin Therapy in Refractory Autoimmune Dysautonomias: A Retrospective Analysis of 38 Patients.

This retrospective analysis explored the use of intravenous immunoglobulin (IVIG) therapy in patients with severe, refractory autoimmune dysautonomias, including those with postural tachycardia syndrome (POTS) and gastrointestinal dysmotility. Among the 38 patients studied, a majority were females with a mean age of 28.4 years. Patients, who were often severely incapacitated despite standard treatments, demonstrated an 83.5% improvement following IVIG therapy, as indicated by significant enhancements in both the composite autonomic symptom scale and functional ability scores. Most patients began responding to treatment within approximately 5.3 weeks, with no serious adverse events reported. Notably, the study found that antiphospholipid antibodies and novel Sjögren antibodies were frequently present in these patients, correlating with high response rates. The researchers suggest considering a 4-month IVIG trial for patients who do not respond to other treatments.