Abstract
Intravenous immunoglobulin (IVIg) has been used successfully for hypogamma-globulinemic states for more than 20 yr. In both primary and secondary situations when hypogammaglobulinemia is of clinical significance, IVIg should be the first line of treatment. In most cases, 400 mg/kg infused every 3 to 4 wk will lead to a trough level higher than 500 mg/dL, which in most cases provides good protection against bacterial infections. Higher doses may be needed in patients with known lung damage.
Side effects include headache, nausea, chills, and fever but can be minimized by lowering the infusion speed rate. Rarely, aseptic meningitis may develop but it is always reversible. Although all products have been shown to be beneficial, differences among the various products have still been reported. In this regard, all products should be standardized according to common accepted international parameters.
The route of immunoglobulin G replacement (intravenously vs subcutaneously) was reported to be of similar benefit. However, guidelines for usage and choice of route should be established and might be of help.
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Durandy, A., Wahn, V., Petteway S, et al. (2005), Int Arch Allergy Immunol 136, 217–229.
Lee, W. I., Kuo, M. L., Huang, J. L., et al. (2005), J Clin Immunol 25, 162–173.
Cunningham-Rundles, C., Bodian, C., Ochs, H. D. et al. (2001), Clin Immunol 100, 181–190.
Manson, D., Reid, B., Dalal, I., et al. (1997), Pediatr Radiol 27, 794–798.
Quartier, P., Debre, M., De Blic, J., et al. (1999), J Pediatr 134, 589–596.
Eijkhout, H. W., van der Meer, J. W. M., Kallenberg, C. G. M., et al. (2001), Ann Intern Med 135, 165–174.
Chapel, H. M., Spicket, G. P., Ericson, D., et al. (2000), J Clin Immunol 20, 94–100.
Gelfand, E. W. (2004), in Intravenous Immunoglobulins in the Third Millennium, Dalakas, M. C. and Spath, P. J., eds. CRC Press, London, pp. 71–76.
Gelfand, E. W., Reid, B., and Roifman, C. M. (1988), Monogr Allergy 23, 177–186.
Roifman, C. M., Schroeder, H., Berger, H., et al. (2003), Int Immunopharmacol 3, 1325–1333.
Roifman, C M, Rao, C. P., Lederman, H. M., et al. (1986), Am J Med 80, 590–594.
Ibanez, C., Sune, P., Fierro, A., et al. (2005), Biodrugs 19, 59–65.
Sewell, W. A., Buckland, M., and Jolles, S. R. (2003), Drugs 63, 1359–1371.
Thickett, K. M., Kumararatne, D. S., Banerjee, A. K., et al. (2002), QJM 95, 655–662.
Kainulainen, L., Varpula, M., Liippo, K., et al. (1999), J Allergy Clin Immunol 104, 1031–1036.
Martinez Garcia, M. A., de Rojas, M. D., Nauffal Manzur, M. D., et al. (2001), Respir Med 95, 191–195.
Quarteir, P., Debre, M., De Blic, J., et al. (1999), J Pediatr 134, 589–596.
Busse, P. J., Razvi, S., and Cunningham-Rundles, C. (2002), J Allergy Clin Immunol 109, 1001–1004.
de Gracia, J., Vendrell, M., Alvarez, A., et al. (2004), Int Immunopharmacol 4, 745–753.
Wahn, V., Good, S., Pahwa, S., et al. (1984), Acta Pathol Microbiol Immunol Scand Suppl 284, 49–58.
WHO/IUIS notice. (1983), Clin Exp Immunol 52, 417–422.
Redwan, E. L. (2002), Hum Antibodies 11, 79–84.
Djoumerrska, I., Tchorbanov, A., Pashov, A., et al. (2005), Scand J Immunol 61, 357–363.
Lebing, W., Remington, K. M., Schreiner, C., et al. (2003), Vox Sang 84, 193–201.
Goldsmith, J. C., Eller, N., Mikolajczyk, M., et al. (2004), Vox Sang 86, 125–129.
Mikolajczy, K. M G., Concepcion, N. F., Wang, T., et al. (2004), Clin Diagn Lab Immunol 11, 1158–1164.
Radinsky, S. and Bonagura, V. R. (2003), J Allergy Clin Immunol 112, 630–633.
Chapel, H. M., Spickett, G. P., Ericson, D., et al. (2000), J Clin Immunol 20, 94–100.
Zebracki, K., Palermo, T. M., Hostoffer, R., et al. (2004), Ann Allergy Asthma Immunol 93, 557–561.
Tcheurekdjian, H., Palermo, T., Hostoffer, R., et al. (2004), Ann Allergy Asthma Immunol 93, 160–165.
Gardulf, A., Nicolay, U., Math, D., et al. (2004), J Allergy Clin Immunol 114, 936–942.
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Toubi, E., Etzioni, A. Intravenous immunoglobulin in immunodeficiency states. Clinic Rev Allerg Immunol 29, 167–172 (2005). https://doi.org/10.1385/CRIAI:29:3:167
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DOI: https://doi.org/10.1385/CRIAI:29:3:167