Pentaglobin in steroid-resistant severe acute respiratory syndrome

• Published in: The international journal of tuberculosis and lung disease Vol. 8; no. 10; pp. 1173 - 1179
• Main Authors: HO, J. C, WU, A. Y, TSANG, K. W, LAM, B, OOI, G. C, KHONG, P-L, HO, P. L, CHAN-YEUNG, M, ZHONG, N-S, KO, C, LAM, W. K
• Format: Journal Article
• Language: English
• Published: Paris, France IUATLD 01-10-2004; Union internationale contre la tuberculose et les maladies respiratoires
• Subjects: Adrenal Cortex Hormones - therapeutic use; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Corticosteroid; Drug Resistance; Female; Human viral diseases; Humans; Immunoglobulin; Immunoglobulin A - administration & dosage; Immunoglobulin A - therapeutic use; Immunoglobulin M - administration & dosage; Immunoglobulin M - therapeutic use; Infectious diseases; Male; Medical sciences; Middle Aged; Pentaglobin; Pneumology; Radiography; Respiratory system : syndromes and miscellaneous diseases; Retrospective Studies; Ribavirin - therapeutic use; SARS coronavirus; Severe Acute Respiratory Syndrome; Severe Acute Respiratory Syndrome - diagnostic imaging; Severe Acute Respiratory Syndrome - therapy; Treatment; Treatment Outcome; Viral diseases; Viral diseases of the respiratory system and ent viral diseases; Infection; Human; Chemotherapy; Immunoglobulins; Treatment; Viral disease; Severe acute respiratory syndrome; IgM
• ISSN: 1027-3719; 1815-7920

SETTING: The treatment of severe acute respiratory syndrome (SARS) is at best controversial, although there is considerable anecdotal experience to show the benefits of corticosteroid therapy for selected patients. Some patients deteriorate relentlessly despite treatment with antibiotic,
corticosteroid and mechanical ventilation.OBJECTIVE: To attempt to determine the clinical efficacy of pentaglobin, an IgM-enriched immunoglobulin preparation, on 12 severe SARS patients who continued to deteriorate despite corticosteroid and ribavirin therapy.DESIGN: Retrospective
analysis of daily quantitative and radiographic data on the cohort in a regional teaching hospital.RESULTS AND CONCLUSION: There was significant improvement in radiographic scores, when compared with day 1, on days 5, 6 and 7 (P < 0.05) after commencement of pentaglobin treatment.
Similarly, there was significant improvement in oxygen requirement, when compared with day 1, on days 6 and 7 (P < 0.05) after commencement of pentaglobin treatment. There were no reported adverse events attributable to pentaglobin administration. Ten patients made an uneventful
recovery after treatment. One elderly man died from cardiorespiratory arrest despite clinical and radiological improvement, and another patient is making good progress. Pentaglobin is safe and probably effective in the treatment of steroid-resistant SARS. A double-blind placebo-controlled
study should therefore be considered.