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supply. Transfus Med, 11$63&74, 2001.
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Japanese Journal of Transfusion Medicine, Vol. 52. No. 3
PRESENT STATUS OF INTRAVENOUS IMMUNOGLOBULIN#IVIG$USAGE"
SURVEY IN JAPAN
Hidefumi Kato1$, Shigeru Takamoto1$, Motoaki Uruma1$, Takanori Ando1$,
Reiko Niwa1$, Hisami Ikeda2$, Kiyoshi Hiruma3$, Takayoshi Asai4$,
Yasutaka Hoshi5$, Yoshiyuki Kurata6$and Masaru Shimizu7$
Department of Transfusion Medicine, Aichi Medical University, 2$Hokkaido Red Cross Blood Center,
3$
Division of Transfusion and Cell Therapy, Tokyo Metropolitan Komagome Hospital,
4$
Shizuoka Red Cross Blood Center,
5$
Department of Transfusion Medicine, Tokyo Jikei University School of Medicine,
6$
Department of Blood Transfusion, Osaka University Hospital,
7$
Department of Laboratory Medicine, Kyorin University School of Medicine
1$
Background Although intravenous immunoglobulin#IVIG$is widely used in clinical practice,
there are no official guidelines for its proper usage in Japan. We have started the preparation of
guidelines for appropriate usage of IVIG, firstly by collecting clinical cases treated with IVIG nationwide.
Methods Questionnaires concerning the number of patients treated with IVIG and the amount
of IVIG used by disease and age#children and adults$from July to September 2003 were sent to 732
hospitals with more than 400 beds.
Results Replies were obtained from 319 hospitals, of which 268#36.6%$were suitable for data
analysis. The number of patients and the amount of IVIG used were 1,955 cases and 28,684 g for children and 6,615 cases and 142,334 g for adults, respectively. Main diseases in children and adults were
infectious diseases#including post-operative infection$in 33% and 73%, autoimmune diseases in 28%
and 10%, and immunodeficiency diseases in 16% and 8%, respectively. The differences between
them were significant. In particular, Kawasaki disease in children was predominant among autoimmune diseases, representing 44.5% of cases. The amount of IVIG used in children was 60% for autoimmune diseases and 17% for immunodeficiency diseases, while that in adults was 45% for infectious
diseases and 35% for autoimmune diseases. Pathogens in these infectious diseases of both children
and adults were bacteria in more than half of the cases, and high CRP values as a factor of severe infection were 28% in children#more than 10 mg!
dl$and 51% in adults#more than 15 mg!
dl$
!
Conclusions These results indicate that IVIG is mainly used in both autoimmune diseases and infectious diseases, and that IVIG is also used in some non-severe infectious diseases.
Key words" intravenous immunoglobulin, surveillance report, autoimmune disease , infectious disease, CRP
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