The Role of Intravenous Immunoglobulin in Decreasing the Level of Procalcitonin in Early Phase of Sepsis: A Prospective Study


The Department of Anesthesia and Pain Management, National Cancer Institute, Cairo University and Saudi German Hospital, Madina, Saudi Arabia


Abstract Background: Intravenous immunoglobulin (IVIG) is used alongside antibiotics in the management of severe infections. Recent reports revealed that IVIG treatment has a mortality benefit in patients with severe sepsis and septic shock. On the other hand, procalcitonin (PCT) is used as biomarker for sever bacterial infections and sepsis. Therefore, we conducted this prospective study toevaluate the role of IVIG in decreasing the serum levels of PCT in the early phase of sepsis. Aim of Study: Tocompare the efficacy of using IVIG in the treatment of patients with early sepsis. Patients and Methods: Forty patients with early sepsis were enrolledin this study from February 2019 to January 2020 and randomly divided into two groups. Twenty patients were treated with commercially available human polyclonal IVIG 0.5gm/kg/day IV infusion for 3 consecutive doses (IVIG group) and twenty were managed with routine sepsis care according to recent guidelines (non-IVIG group). Results: The majority of the study patients were males (62.5%). The IVIG and non-IVIG study groups were compa-rable in terms of age (p=0.33) and baseline PCT levels (p=0.26). We observed significant differences between the IVIG and non-IVIG study groups in terms of serum PCT levels, being significantly lower in the IVIG group at all the three time points (p=0.03, 0.002, and 0.003 at 1, 3 and 7 days of admission, respectively). Conclusion: In conclusion, the use of IVIG at 0.5gm/ kg/day IV infusion for three days was associated with signif-icant reductions in serum PCT levels after one day, extending to one week of admission in patients with early sepsis. These results sum up with the evidence on the potential of IVIG in the treatment of early sepsis and larger, longer follow-up studies are recommended for confirmation.