ArticleEuropean journal of pediatrics2026
Early hematologic cellular effects of IgM-enriched intravenous immunoglobulin in pediatric sepsis: a retrospective cohort study.
Article in European journal of pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Immune dysregulation plays a central role in the pathophysiology of pediatric sepsis, prompting interest in adjunctive immunomodulatory therapies. IgM-enriched intravenous immunoglobulin (IgM-IVIG) has been used in selected cases of severe pediatric sepsis; however, evidence supporting its use remains limited and inconsistent. In this retrospective propensity score-matched cohort study, we evaluated early laboratory and clinical changes associated with IgM-IVIG therapy in children admitted to a tertiary pediatric intensive care unit with sepsis or septic shock. A total of 74 patients were included, of whom 37 received IgM-IVIG. Baseline demographic characteristics and disease severity scores were similar between groups. Patients treated with IgM-IVIG required more intensive organ support and had longer pediatric intensive care unit stays, while mortality rates did not differ significantly between groups. Within the first 24 h following IgM-IVIG administration, significant reductions in leukocyte and neutrophil counts were observed, accompanied by a decrease in platelet counts and an increase in mean platelet volume. No significant changes were detected in lactate levels, vasoactive-inotropic score, or other systemic inflammatory markers.
conclusionAdjunctive IgM-enriched intravenous immunoglobulin therapy in pediatric sepsis was associated with early cellular and hematological changes suggestive of immunomodulatory activity; however, these biological effects did not translate into measurable clinical benefit. Further prospective pediatric studies are needed to better define patient subgroups that may benefit from targeted immunomodulatory interventions. WHAT IS KNOWN: • Pediatric sepsis is associated with complex immune dysregulation and high morbidity and mortality. • Evidence supporting the clinical benefit of IgM-enriched intravenous immunoglobulin in pediatric sepsis is limited. WHAT IS NEW: • IgM-enriched intravenous immunoglobulin is associated with early changes in leukocyte, neutrophil, and platelet indices in pediatric sepsis. • These early cellular effects do not appear to translate into improved clinical outcomes.
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