Is Kevie going to get solumedrol 20 mg on day 3 of the IV IgG? It seems like a good idea. There is pretty good documentation of steroids helping the side effects of IV IgG. I have read it and heard it discussed at national conferences. It does not work for everyone and most people have higher doses of steroids than this, but the point is to use what works. If this does not work to lessen side effects, Kevie might need a higher dose, but it is worth trying smaller and then increasing.
Immunologically, it does not make a lot of sense to give 3 g/kg immunoglobulin–this is so much. Replacement doses for people that do not make their own immunoglobulin is 0.4 g/kg. People load with 2 g/kg to “flood” the system to stop production of “bad” antibody in autoimmune diseases. Often than people used 1 g/kg to keep self-production shut off. Again, you want to use what works and what works varies for different people, but more is not always better. I would guess that if you have to go so high on a dose to see a response, doctors should be trying alternatives.
YES for remission and YES for hope. Kevie, very fortunately, appears to be very responsive to IV IgG with rapid and pretty good reversal of many of the bad manifestations of the disease. It takes some time to recover and not all the manifestations are due to immunoglobulin attack. The demyelination part of CIDP has to heal and immunoglobulin will not speed healing, just keeps more damage from happening so healing can happen. Always hold to hope.
With Hope for cure of these diseases