Volume 16, Number 2
This Infusion Center's in an
IV League of its Own
Several years ago, Baltimore detective Marlene Green wondered if she'd have to give up her badge. She'd hear her speech slurring and feel embarrassed. Her spells of double vision began to linger. And the fatigue! She had to drag her bone-weary self to crime scenes. Twelve doctors and one eye patch later, she felt no better. "One day," she explains, "a woman I didn't know commented on my speech and eye patch. 'My daughter had that,' she told me, 'and was diagnosed at Johns Hopkins with myasthenia gravis. Now she's fine.' I started to bawl right there in the credit union," says Green. "I think I'd lost hope."
Today
Green, who does indeed have MG, is leading a full, active life. The main
reminder of her disease, which is an autoimmune disorder that disrupts normal
nerve transmission to muscles, is her occasional trip to the Neurology Infusion
Center at Johns Hopkins when she feels symptoms returning. For several days,
she receives an infusion of antibodies to waylay immune attack. "We don't
know precisely how intravenous immunoglobulin (IVIg) infusion works, says
center Director Vinay Chaudhry, M.D., "but it has turned many patients'
lives around."Chaudhry, a neurologist specializing in neuromuscular disease, opened the center last winter to provide IV infusions in an outpatient setting. "Patients used to be admitted to hospital for this," says Chaudhry. Now some private firms, he says, do IVIg treatments in the home. "But we had concerns about that and chose an approach that we think best combines convenience and safety."
Some of the conditions for which the treatment is used include MG, Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, multifocal motor neuropathy and polymyositis, all neurological autoimmune ills. Chaudhry suspects that infusing patients with immune proteins pooled from thousands of blood donors may act like a red herring to divert the body's own antibodies from tissue targets. Or, he says, perhaps the added proteins somehow alter the immune system-its cells or inflammatory molecules-directly. More than a decade's use and several double-blind studies, however, show the technique works.
The center also gives immune-damping high-dose steroids, rituximab or Remicade on occasion. But the operation's not an Infusions R Us. "Our benefits lie in more than variety," says Chaudhry. He personally reviews diagnoses and weighs treatment options. "And because every patient is different and our protocols are tight, we sometimes turn people down."
Direct supervision and follow-up care are Center hallmarks, as is educating patients while they're held in IV "captivity." In addition, there's expertise in negotiating insurance concerns. "Because the sessions cost up to $15,000, we're scrupulous about accepting only those likely to be helped. Unfortunately, because treatment is lucrative for some companies, it's been misused. We know patients who've gotten infusions for the wrong reasons. That wouldn't happen here."
For more information, call 410-614-1307.