Back to the Future? Immunoglobulin Therapy for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, 2021, Brownlie and Speight

All the evidence seems to be not quite what one needs to be sure.
Comparisons with other therapies showing the same 'benefit' begs the question as to how much that really is. There is a problem with comparison with 'current best treatment' trials.

It may well be that IVIG is of real benefit for some of these conditions but in the past its use in rheumatology was largely based on mythology as far as I could see. Some patients improve but most of them are on steroids and other things as well.

Coming back to the relevance to ME, I think that if ME was an IVIG responsive disease we would have seen at least some benefit from rituximab and we didn't.

 

As the discussion has drifted more specifically to SFN & receptor antibodies I wanted to share this video:


Its a general roundup/opinion of autoimmunity involvement in POTS/SFN by Taylor Doherty MD, an immunologist/associate prof of medicine. There's a discussion of a 38 patient case study showing improvement in refractory autoimmune dysautonomias after IVIG - still only retrospective, though randomised clinical trials are underway.

Interestingly Taylor details his own personal experience of severe post-infectious POTS. He details his receptor activity results, then his temporary remission after plasmapheresis, then a longer lasting remission after several doses of Rituximab.