The use of IVIg in the treatment of inflammatory polyneuropathies and myasthenia gravis at The Walton Centre


Background Immunoglobulin is a blood product used in a variety of medical disorders, usually delivered intravenously (IVIg). Neurology patients, particularly those with inflammatory polyneuropathy, utilise a lot of IVIg.  There is a national shortage of immunoglobulin and, thus, pressing need to ensure minimum effective dosing as well as rigorous outcome assessments to assess benefit at treatment start and subsequently, as placebo effects can be strong.

Missed opportunities to diagnose syphilis prior to the development of sight-losing uveitis

 

The incidence of syphilis in the UK is rapidly rising. Uveitis (intraocular inflammation) usually occurs in the secondary or later stages of syphilis infection and is sight-threatening.

Methods A retrospective analysis of the demographics, presentation, diagnosis, treatment and outcomes of patients with syphilitic uveitis managed in Newcastle from 2005–2016 was carried out.

New biologics for rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic inflammatory arthritis with many systemic manifestations. Several monoclonal antibodies targeting different components of the immune systems have been licensed for treatment of RA. Inflammatory cytokines such as interleukin-6 (IL-6) are found abundantly in the blood and the joints. The biologic effect of IL-6 on leukocyte, osteoclast, hepatocytes and bone marrow may mediate the articular and systemic inflammation in RA.

Ischaemic stroke – prevention is better than cure

This review is based on a presentation by Professor Hankey at the RCPE Neurology Symposium on 27 November 2009.

Keywords Evidence, health policy, ischaemic stroke, prevention, randomised trials, treatment

Declaration of Interests Professor Hankey has received honoraria for speaking at scientific symposia sponsored by Sanofi Aventis, Boehringer Ingelheim, Bristol Myers Squibb and Pfizer. He has also consulted on advisory boards.

New biologics for rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic inflammatory arthritis with many systemic manifestations. Several monoclonal antibodies targeting different components of the immune systems have been licensed for treatment of RA. Inflammatory cytokines such as interleukin-6 (IL-6) are found abundantly in the blood and the joints. The biologic effect of IL-6 on leukocyte, osteoclast, hepatocytes and bone marrow may mediate the articular and systemic inflammation in RA.

Our approach to the diagnosis and treatment of polymyalgia rheumatica and giant cell (temporal) arteritis

We believe there is a strong case for formalised collaborative care between GPs and  rheumatologists in the management of polymyalgia rheumatica (PMR) and giant cell arteritis (GCA), which can be difficult conditions to diagnose and manage. Our rapid access diagnostic care pathways allow early referral of patients who appear to have PMR or GCA, before  glucocorticoids are prescribed.