Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Immunoglobulins (specifically, intravenous immunoglobulin or IVIG) have been investigated as a potential therapy for rheumatic fever, particularly in severe or refractory cases. However, the scientific evidence supporting their routine use in rheumatic fever is limited and not robust. The standard of care for rheumatic fever remains antibiotics (to eradicate Group A Streptococcus), anti-inflammatory agents (such as aspirin or corticosteroids), and supportive care. Some case reports and small series have described the use of IVIG in severe rheumatic carditis, citing its immunomodulatory and anti-inflammatory effects. These reports suggest potential benefit in reducing inflammation or cardiac damage in selected cases, especially when conventional therapies fail or are contraindicated.

However, there are no large randomized controlled trials or strong guideline recommendations supporting IVIG as a routine treatment for rheumatic fever. Most major guidelines (such as those from the American Heart Association) do not list immunoglobulin therapy as a standard or adjunctive treatment. The evidence, therefore, is weak (rated 2/5), based on limited observational data and case reports rather than high-quality clinical trials. The use of immunoglobulins in rheumatic fever remains experimental and is reserved for exceptional cases where standard therapies are insufficient. In summary, while there is some scientific rationale for the use of immunoglobulins in rheumatic fever, its use is not widely validated or recommended in clinical practice.

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