Side-effects of intravenous immune globulins.
PubMedPublished 1 July 1994Open access
Caroline Duhem, Mario Dicato, F. Ries
Citations209
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TL;DR
Most of the adverse experiences with IVIG reported in the literature since its introduction into clinical practice almost 15 years ago are summarized.
Abstract
Intravenous immune globulin (IVIG) preparations are efficacious and safe products in use world-wide. Although rare, side-effects of IVIG may be serious, even life-threatening, and clinicians should be aware of their potential occurrence. This article summarizes most of the adverse experiences with IVIG reported in the literature since its introduction into clinical practice almost 15 years ago.
Keywords
Immunology and MicrobiologyMedicine
New England Journal of MedicineManipulating the Immune System with Immune Globulin
650 Citations1992John A. Oates, Alastair J.J. Wood +1 more
Many years of immunochemical research were required before a concentrated, biologically active, and safe preparation of immune globulin suitable for intravenous use became available.
New England Journal of MedicineAnaphylactic Reactions after Gamma Globulin Administration in Patients with Hypogammaglobulinemia
325 Citations1986A. Wesley Burks, Hugh A. Sampson +1 more
Although such patients have severe defects in antibody production, they often retain the ability to produce autoantibodies and it is important to find ways to circumvent these life-threatening anaphylactic reactions and to provide adequate replacement therapy.
The LancetEFFECT OF INTRAVENOUS IMMUNOGLOBULIN IN IMMUNE THROMBOCYTOPENIA
307 Citations1983A. Salama, C. Mueller‐Eckhardt +1 more
Measurement of haptoglobin levels, a sensitive indicator of haemolysis, suggests that clinically inapparent haemophilia occurs during immunoglobulin therapy of ITP patients, and in-vitro experiments confirm that there is immunoglobeulin coating of red blood cells.
The LancetTreatment of systemic vasculitis with pooled intravenous immunoglobulin
299 Citations1991David Jayne, C M Lockwood +3 more
Investigation in patients with systemic vasculitis found IVIg seemed to confer a useful therapeutic effect without adverse reaction, and the fall in ANCA concentrations to a mean of 51% of the pre-treatment values was maintained during follow-up.
The LancetNON-A, NON-B HEPATITIS OCCURRING IN AGAMMAGLOBULINAEMIC PATIENTS AFTER INTRAVENOUS IMMUNOGLOBULIN
216 Citations1984Andrew Lever, David J. Brown +2 more
The finding that the virus can be transmitted in IgG concentrates suggests either that the general population has a very low level of antibodies to the putative virus or that such antibodies are not virus-neutralising.
The LancetEffect of high-dose intravenous immunoglobulin therapy on blood rheology
205 Citations1992Walter H. Reinhart, Peter Berchtold
The changes in viscosity that occur after IVIG therapy can impair blood flow, and in patients at risk of cardiovascular and thromboembolic events they might be sufficient to produce myocardial infarction or stroke.
The LancetSoluble CD4, CD8, and HLA molecules in commercial immunoglobulin preparations
179 Citations1993Rainer Blasczyk, Ulrike Westhoff +1 more
It is possible that the immunomodulating effects of immunoglobulin therapy in disorders with immune aetiology are due, at least partly, to these contaminating molecules.
The American Journal of MedicineIntravenous immunoglobulin prophylaxis causing liver damage in 16 of 77 patients with hypogammaglobulinemia or IgG subclass deficiency
156 Citations1988Janne Björkander, Charlotte Cunningham-Rundles +4 more
Sixteen of 77 patients with common variable immunodeficiency or IgG subclass deficiency contracted non-A, non-B hepatitis in association with intravenous infusions of immunoglobulin, and the hepatitis seemed to run a more severe course in these patients than in non-immunodeficient patients.
Archives of NeurologyAcute Renal Failure Resulting From Intravenous Immunoglobulin Therapy
148 Citations1993Eugene Tan, Melkon Hajinazarian +3 more
Renal biopsies performed during acute renal failure in each patient demonstrated marked swelling and vacuolization of the proximal tubular epithelial cytoplasm typical of high-solute-load-induced damage (similar to that associated with the use of mannitol).
The LancetHigh-dose intravenous IgG treatment and renal function
92 Citations1991Jürg A. Schifferli, M Leski +4 more
In an open trial of high dose intravenous IgG (IVIG) treatment in nephrotic patients with glomerulonephritis, the first six patients showed a transient rise in plasma creatinine, suggesting that high-dose IVIG infusion can produce short-lived disturbances in renal function in patients with kidney diseases.
The American Journal of MedicineAcute cryoglobulinemic renal failure after intravenous infusion of gamma globulin
92 Citations1987James C. Barton, Guillermo A. Herrera +4 more
Observations strongly suggest that complexes consisting of IgM kappa rheumatoid factor, IgG, and complement initiated the renal damage in a 39-year-old woman with mixed IgM/IgG cryoglobulinemia, which should be considered a contraindication to the administration of intravenous gamma globulin.
The Journal of PediatricsImmune hemolysis, disseminated intravascular coagulation, and serum sickness after large doses of immune globulin given intravenously for Kawasaki disease
83 Citations1992Raymond L. Comenzo, Marie E. Malachowski +3 more
Clinicians should be aware that immune globulin preparations contain antibodies to blood-type antigens that may cause significant hemolysis and disseminated intravascular coagulation.
PubMedPulmonary and renal toxicity of intravenous immunoglobulin.
74 Citations1991Raymond Rault, Beth Piraino +2 more
Three patients treated with intravenous immunoglobulin developed respiratory difficulty and decreased renal function and the fact that all three cases occurred with a particular immunoglobeulin preparation would suggest that a contaminant, possibly aggregated IgG might be responsible.
The American Journal of MedicineHemolytic anemia following intravenous gamma globulin administration
70 Citations1987Alan Brox, Denis Cournoyer +2 more
A young homosexual man with immune thrombocytopenia recently had transient intravascular hemolysis during intravenous gamma globulin treatment, which may result in crossmatching difficulties and should be recognized as a potential complication of therapy.
JAMAAdministration of Immune Globulin Associated With Aseptic Meningitis
66 Citations1988Eiji Kato
A 2-year-old girl was admitted to the hospital on April 29, 1986, for treatment of acute idiopathic thrombocytopenic purpura, and was treated with 20 mg/d of corticosteroids for four weeks, but no rise in platelet count occurred.
Tissue AntigensSoluble HLA class I and class II concentrations in commercial immunoglobuh preparations
57 Citations1992H. Grosse‐Wilde, Rainer Blasczyk +1 more
Based on the total dosage of intravenously administered immunoglobulins (i.v.Ig), contaminating sHLA molecules may become immunogenic, suggesting that the extraction procedure may concentrate not only Ig, but also HLA class II molecules.
Journal of Neurology Neurosurgery & PsychiatryAseptic meningitis associated with high dose intravenous immunoglobulin therapy.
50 Citations1991J D Watson, John Gibson +2 more
Two cases of aseptic meningitis occurred in temporal association with high dose intravenous immunoglobulin therapy to treat thrombocytopenia, which has been reported in only one previous paediatric case.
NeurologyRecurrent aseptic meningitis complicating intravenous immunoglobulin therapy for chronic inflammatory demyelinating polyradiculoneuropathy
47 Citations1992Mayra Vera-Ramirez, Michael Charlet +1 more
New England Journal of MedicineRecurrent Migraine and Intravenous Immune Globulin Therapy
37 Citations1993Cris S. Constantinescu, Andrew P. Chang +1 more
A patient in whom migraine developed after his first intravenous immune globulin treatment, and propranolol prevented subsequent treatment-associated headaches is reported on.
Journal of Hospital InfectionClinical safety of intravenous immune globulin and freedom from transmission of viral disease
13 Citations1988Ralph H. Rousell
Evidence of the inactivation of human immunodeficiency virus during the manufacturing procedure is provided and data are provided which support the absence of transmission of human immune deficiency virus in idiopathic thrombocytopenia patients, and the agents of non-A, non-B hepatitis in 41 immune-deficient patients having periods of follow-up ranging up to 18 months.