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However, most usage is for off\u2010label indications, and for some of these comprehensive guidelines have been published.<\/jats:p><jats:p><jats:bold>STUDY DESIGN AND METHODS:\u2002<\/jats:bold> We retrospectively reviewed all approved IVIG transfusions at Massachusetts General Hospital in 2004 to identify the current usage pattern and completed a literature review.<\/jats:p><jats:p><jats:bold>RESULTS:\u2002<\/jats:bold> IVIG was most commonly used in the treatment of chronic neuropathy, which included chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy. For such patients, the annual cost of IVIG can exceed $50,000 per patient. Other common indications were the treatment of hypogammaglobulinemia, ITP, renal transplant rejection, myasthenia gravis, Guillain\u2010Barre syndrome, necrotizing fasciitis, autoimmune hemolytic anemia, and Kawasaki disease. IVIG was administered in a variety of other indications each representing &lt;3% of the total treated patients.<\/jats:p><jats:p><jats:bold>CONCLUSION:\u2002<\/jats:bold> Only a few indications account for most of the usage for IVIG. Reports concerning IVIG continue to grow at a tremendous pace but few high\u2010quality randomized controlled trials have been reported. Randomized trials are especially needed for conditions such as CIDP, which consume large quantities of product.<\/jats:p>","DOI":"10.1111\/j.1537-2995.2006.00792.x","type":"journal-article","created":{"date-parts":[[2006,5,4]],"date-time":"2006-05-04T15:05:58Z","timestamp":1146755158000},"page":"741-753","source":"Crossref","is-referenced-by-count":117,"title":["Current usage of intravenous immune globulin and the rationale behind it: the Massachusetts General Hospital data and a review of the literature"],"prefix":"10.1111","volume":"46","author":[{"given":"Kamran","family":"Darabi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Abdel\u2010Wahab","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter H.","family":"Dzik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,5,4]]},"reference":[{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.2003.00519.x"},{"key":"e_1_2_8_3_2","volume-title":"Technology assessment: intravenous immunoglobulin preparationos.","author":"Ratko T","year":"1999"},{"key":"e_1_2_8_4_2","volume-title":"Facts and Figures [database on the Internet].","year":"2004"},{"key":"e_1_2_8_5_2","volume-title":"Result of the UHC intravenous immunoglobulin multicenter drug surveillance study.","author":"Chen C","year":"1998"},{"key":"e_1_2_8_6_2","volume-title":"The Pink Sheet.","year":"1998"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(81)92400-4"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra010501"},{"key":"e_1_2_8_9_2","doi-asserted-by":"publisher","DOI":"10.4065\/79.4.504"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)92205-5"},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(94)90048-5"},{"key":"e_1_2_8_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)07275-6"},{"key":"e_1_2_8_13_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.1999.01766.x"},{"key":"e_1_2_8_14_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.9.6.722"},{"key":"e_1_2_8_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(99)70246-5"},{"key":"e_1_2_8_16_2","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2002.124999"},{"key":"e_1_2_8_17_2","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2003.86"},{"key":"e_1_2_8_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(87)90494-6"},{"key":"e_1_2_8_19_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-135-3-200108070-00008"},{"key":"e_1_2_8_20_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.med.48.1.93"},{"key":"e_1_2_8_21_2","doi-asserted-by":"publisher","DOI":"10.4065\/75.10.1039"},{"key":"e_1_2_8_22_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198810063191403"},{"key":"e_1_2_8_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1994.tb05002.x"},{"key":"e_1_2_8_24_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199107113250202"},{"key":"e_1_2_8_25_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1701742"},{"key":"e_1_2_8_26_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1703109"},{"key":"e_1_2_8_27_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-106-1-12"},{"key":"e_1_2_8_28_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199009133231103"},{"key":"e_1_2_8_29_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-139-1-200307010-00007"},{"issue":"8","key":"e_1_2_8_30_2","first-page":"1","article-title":"Guidelines for preventing opportunistic infections among HIV\u2010infected persons\u20142002. 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