Abstract：
OBJECTIVE: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) remains an enigma with no curable treatment options at hand. Although patients with ME/CFS are a heterogeneous group, a large proportion of patients present with an infection-driven symptomatology, making them potential responders to immunologic treatments, such as immunoglobulin (IG). Previous studies on IG treatment in patients with ME/CFS have not been consistent but have described beneficial effects in subgroups of patients.
METHODS: Here we present data on a series of cases (n = 17) with infection-related ME/CFS (as defined by disease history and ongoing recurrent infections) treated with subcutaneous low-dose IG (0.06 g/kg/mo) over 5 weeks with continuous monitoring of symptoms.
RESULTS: Patients were predominantly female (65%) with mild-to-moderate disease severity (82%) and with poor self-reported quality of life (median, 25 on a 0-100 scale) and working ability (median, 5 on a 0-100 scale) before treatment. After 5 weeks of treatment with low-dose IG, significant improvements in symptoms, quality of life, and working ability were noted (all P < 0.05). Among the 7 patients who reported the highest benefit of the treatment, quality of life increased by 35 units (on a 0-100 scale), with 1 patient reporting complete elimination of ME/CFS symptoms. No serious side effects were detected with the treatment.
CONCLUSIONS: In this limited-sized case series, we found pronounced beneficial effects of low-dose IG in a large proportion of patients with infection-related ME/CFS. Further well-controlled studies are needed to verify the potential benefits of IG treatment in patients with ME/CFS with infection-driven symptomatology.
METHODS: Here we present data on a series of cases (n = 17) with infection-related ME/CFS (as defined by disease history and ongoing recurrent infections) treated with subcutaneous low-dose IG (0.06 g/kg/mo) over 5 weeks with continuous monitoring of symptoms.
RESULTS: Patients were predominantly female (65%) with mild-to-moderate disease severity (82%) and with poor self-reported quality of life (median, 25 on a 0-100 scale) and working ability (median, 5 on a 0-100 scale) before treatment. After 5 weeks of treatment with low-dose IG, significant improvements in symptoms, quality of life, and working ability were noted (all P < 0.05). Among the 7 patients who reported the highest benefit of the treatment, quality of life increased by 35 units (on a 0-100 scale), with 1 patient reporting complete elimination of ME/CFS symptoms. No serious side effects were detected with the treatment.
CONCLUSIONS: In this limited-sized case series, we found pronounced beneficial effects of low-dose IG in a large proportion of patients with infection-related ME/CFS. Further well-controlled studies are needed to verify the potential benefits of IG treatment in patients with ME/CFS with infection-driven symptomatology.
摘要：
目的：肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS）仍然是一个谜，目前尚无可治愈的治疗选择。尽管ME/CFS患者是一个异质性群体，大部分患者出现感染驱动的症状，使他们成为免疫疗法的潜在反应者，如免疫球蛋白(IG)。先前关于IG治疗ME/CFS患者的研究并不一致，但已描述了患者亚组的有益效果。
方法：在此，我们提供了一系列（n=17）感染相关的ME/CFS（定义为疾病史和持续复发感染）患者接受皮下低剂量IG（0.06g/kg/mo）治疗5周的连续症状监测的数据。
结果：患者主要为女性（65％），疾病严重程度为轻度至中度（82％），自我报告的生活质量较差（中位数，25在0-100量表上)和工作能力(中位数，5在0-100规模内)治疗前。低剂量IG治疗5周后，症状明显改善，生活质量,工作能力均有显著性差异(均P<0.05)。在报告治疗获益最高的7名患者中，生活质量增加了35个单位（在0-100量表上），1例患者报告ME/CFS症状完全消除。治疗中未检测到严重的副作用。
结论：在这个有限的病例系列中，我们发现低剂量IG在大部分感染相关ME/CFS患者中具有显著的有益效果.需要进一步的良好对照研究来验证IG治疗对具有感染驱动症状的ME/CFS患者的潜在益处。
方法：在此，我们提供了一系列（n=17）感染相关的ME/CFS（定义为疾病史和持续复发感染）患者接受皮下低剂量IG（0.06g/kg/mo）治疗5周的连续症状监测的数据。
结果：患者主要为女性（65％），疾病严重程度为轻度至中度（82％），自我报告的生活质量较差（中位数，25在0-100量表上)和工作能力(中位数，5在0-100规模内)治疗前。低剂量IG治疗5周后，症状明显改善，生活质量,工作能力均有显著性差异(均P<0.05)。在报告治疗获益最高的7名患者中，生活质量增加了35个单位（在0-100量表上），1例患者报告ME/CFS症状完全消除。治疗中未检测到严重的副作用。
结论：在这个有限的病例系列中，我们发现低剂量IG在大部分感染相关ME/CFS患者中具有显著的有益效果.需要进一步的良好对照研究来验证IG治疗对具有感染驱动症状的ME/CFS患者的潜在益处。
