Ivig

Immunomodulation; decreases infections

Flu-like post-infusion symptoms; potential blood product risks that can trigger relapses

Rituximab

Selective against B cells

Low risk of allergic reaction to murine component; long-term effects unknown

Drugs

Corticosteroids

May be appropriate for mild cases; ease of administration; well known drug profile

Cushingoid side effects; ineffective in many cases

Azathioprine

Immunosuppressant; easy to use and well tolerated; drug levels can be monitored

Takes several months to see effect

Mycophenolate

Newer inhibitor of lymphocyte proliferation; may be more effective than azathioprine

Long-term effects unknown

Cyclophosphamide

Useful treatment for neuroblastoma; well-known drug profile

Dose-dependent reproductive side effects; not effective in some OMS

6-Mercaptopurine

Established role as "steroid sparer"in other disorders; low toxicity;ease of administration

No data in OMS

Methotrexate

A useful immunotherapy in some chronic autoimmune neurologic disorders; well-known drug profile

No data in OMS

Pheresis Plasmapheresis

Therapy directed at autoantibodies

Technically not feasible in infants and toddlers; may cause antibody rebound; should not be used as monotherapy; limited data

Immunoadsorption

More effective at removing antibody load

Expensive; technical expertise required; limited data

Leukocytopheresis

Allows selective removal of lymphocyte populations

No data in OMS

Treatments from different classes or within the same class may be combined

Treatments from different classes or within the same class may be combined

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