How effective immunoglobulin therapy is in the management of post polio syndrome ? Algerian observational study 2019

Abstract

Introduction :The prevalence of post polio syndrome (PPS) in Algeria is 48.7% according to our study established in 2016 1) Recent studies have been able to strengthen the inflammatory hypothesis in the genesis of post-polio syndrome. Thus cytokines were found in the cerebrospinal fluid of patients with post polio syndrome (PPS) 2) PATIENTS AND METHOD: the idea of an immunomodulatory therapy based on intravenous immunoglobulin (IVIG) could reduce inflammation, and would most likely have clinical benefits, including muscle strength, and an improvement in the activity of the patient. quality of life, this has already been reported by Borg et al, for a duration of one year 3) whose evidence has been advanced by biomarkers with a significant correlation to the beneficial results of this IVIG treatment. In this patient population, it is therefore important to know the wrong responder and who will benefit from this IVIG management. We have noted an increase in the need for care in this population, for this we have started a study, the objectives, is to first assess the e ectiveness of GI IV and certainly the safety of this treatment in the PPS 4) Prospective observational study, open from 2017 to 2019, of 6 women (including 4 singles and 2 married women), and 3 men (2 of whom are single and 1 married). the diagnosis of post polio syndrome is conducted according to the criteria established by Halstead and Dalakas. The measurement criteria before and a er treatment with immunoglobulins of the Privigen type, at a dose of 0.4 mg / kg 2] from D1 to D5 each month, for 4 months, are: EVA-pain, Borg scale, perimeter of walking, 10 m walking test, and the 6-min walk test, satisfaction-patient and measurement of muscle strength on manual testing and measurement of grip strength at the conventional dynamometer. RESULTS: The average age of our population is 42.2 ± 9.5 28-56). The average onset time is 4.33 years. Average patient satisfaction (60.5%). The improvement is significant on: pain P=0.0001), fatigue P =0.0001 Fig2), walking perimeter with a gain of 981m (Fig4), and improvement of Pain is inversely proportional to the onset of PPS. There is also an improvement in the grip force on the dynamometer, very significant on the le Fig3). The 10m” and 06mn” walk tests returned very significant. There is no improvement in muscle strength on "muscle testing". The strong responders to treatment are those with a recent onset of post-polio syndrome. Side e ects are very rare. DISCUSSION AND : In our study IV Ig represent an e ective treatment in PPS, especially on fatigue and pain.The results of our are closer to the results of ILa ont team 2] and those of H Gonzalez 3]in improving pain and fatigue, contrary to what was concluded in the study. analysis of randomized and prospective studies, Yao-Hsien Huang et al, that Ig IV produce improvement in pain, fatigue and muscle strength in PPS Given our preliminary results, it seems interesting to conduct a randomized multicentre Maghreb study.