Kinetics of Immunoglobulins in Septic Shock Patients Treated with an IgM and IgA-Enriched Intravenous Preparation: an Observational Study

Objective to assess the variations of the blood levels of immunoglobulins (Ig) in septic shock patients treated with an Ig preparation enriched in IgM and IgA (eIg). Design The blood levels of Ig in survivors (S) and non-survivors (NS) of a group of septic shock patients were measured before the initial administration (D0) and one (D1), four (D4) and seven (D7) days thereafter. The SAPS II score, the capillary permeability, the primary site of infection, the antibiotic appropriateness, the microorganisms isolated and the outcome at 28 days were also assessed. Results In the interval D0-D7 the IgM increased significantly only in the S while remained stable in NS; the IgA significantly increased in both groups; the IgG did not vary significantly in both groups. At D7 the capillary permeability significantly decreased in S but not in NS. Conclusions The kinetics of the different classes of Ig after eIg were different between S and NS. This could be related either to (a) different capillary permeability in the two groups and/or (b) higher Ig consumption in NS. Further studies to confirm the benefits of eIg in the treatment of sepsis syndrome, to define the specific target population and the correct eIg dose are warranted.