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Suppression of Secondary Antibody Response by Intravenous Immunoglobulin in a Patient with Haemophilia B and Antibodies

Nilsson, I. M. ; Sundqvist, S. ‐B ; Ljung, R. LU orcid ; Holmberg, L. LU ; Freiburghaus, Catja LU and Björlin, G. (1983) In Scandinavian Journal of Haematology 30(5). p.458-464
Abstract

A 39‐year‐old patient, suffering from severe haemophilia B and antibodies against factor IX, has twice been treated with extracorporeal protein A‐Sepharose adsorption followed by conventional substitution therapy in combination with immunosuppression (cyclophos‐phamide). On both occasions, separated by a 2‐year interval, the same procedure was followed except that, on the second, administration of i.v. immunoglobulin (Gammonativ, KabiVitrum) was added. Within a week of the first treatment the patient developed a 15‐fold increase in the antibody titre. Following the second treatment described here, no secondary antibody response could be detected, and after a further 12 weeks only traces of antibodies are demonstrable. It seems that... (More)

A 39‐year‐old patient, suffering from severe haemophilia B and antibodies against factor IX, has twice been treated with extracorporeal protein A‐Sepharose adsorption followed by conventional substitution therapy in combination with immunosuppression (cyclophos‐phamide). On both occasions, separated by a 2‐year interval, the same procedure was followed except that, on the second, administration of i.v. immunoglobulin (Gammonativ, KabiVitrum) was added. Within a week of the first treatment the patient developed a 15‐fold increase in the antibody titre. Following the second treatment described here, no secondary antibody response could be detected, and after a further 12 weeks only traces of antibodies are demonstrable. It seems that antibody synthesis was suppressed by the i.v. immunoglobulin. No evidence was found to demonstrate that the effect was due either to a non‐specific suppression of the immune and reticuloendothelial systems or to the action of interfering antibodies. It has not yet been established whether or not the protein A‐Sepharose adsorption technique, or the immunosuppressive treatment, contributed in any way to the result. The observations suggest a new approach to the treatment of haemophiliacs with antibodies of the high‐responding type.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
antibody, antibody suppression, f IX inhibitor assay, haemopbilia B, immunoglobulin i.v., protein A‐Sepharose adsorption
in
Scandinavian Journal of Haematology
volume
30
issue
5
pages
458 - 464
publisher
Wiley-Blackwell
external identifiers
  • pmid:6190216
  • scopus:0020611807
ISSN
0036-553X
DOI
10.1111/j.1600-0609.1983.tb02534.x
language
English
LU publication?
yes
id
c5f65a7e-849a-43a7-ae41-00e869cf5883
date added to LUP
2016-11-08 15:25:17
date last changed
2024-01-04 16:00:28
@article{c5f65a7e-849a-43a7-ae41-00e869cf5883,
  abstract     = {{<p>A 39‐year‐old patient, suffering from severe haemophilia B and antibodies against factor IX, has twice been treated with extracorporeal protein A‐Sepharose adsorption followed by conventional substitution therapy in combination with immunosuppression (cyclophos‐phamide). On both occasions, separated by a 2‐year interval, the same procedure was followed except that, on the second, administration of i.v. immunoglobulin (Gammonativ, KabiVitrum) was added. Within a week of the first treatment the patient developed a 15‐fold increase in the antibody titre. Following the second treatment described here, no secondary antibody response could be detected, and after a further 12 weeks only traces of antibodies are demonstrable. It seems that antibody synthesis was suppressed by the i.v. immunoglobulin. No evidence was found to demonstrate that the effect was due either to a non‐specific suppression of the immune and reticuloendothelial systems or to the action of interfering antibodies. It has not yet been established whether or not the protein A‐Sepharose adsorption technique, or the immunosuppressive treatment, contributed in any way to the result. The observations suggest a new approach to the treatment of haemophiliacs with antibodies of the high‐responding type.</p>}},
  author       = {{Nilsson, I. M. and Sundqvist, S. ‐B and Ljung, R. and Holmberg, L. and Freiburghaus, Catja and Björlin, G.}},
  issn         = {{0036-553X}},
  keywords     = {{antibody; antibody suppression; f IX inhibitor assay; haemopbilia B; immunoglobulin i.v.; protein A‐Sepharose adsorption}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{458--464}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Scandinavian Journal of Haematology}},
  title        = {{Suppression of Secondary Antibody Response by Intravenous Immunoglobulin in a Patient with Haemophilia B and Antibodies}},
  url          = {{http://dx.doi.org/10.1111/j.1600-0609.1983.tb02534.x}},
  doi          = {{10.1111/j.1600-0609.1983.tb02534.x}},
  volume       = {{30}},
  year         = {{1983}},
}