Asia Pac Allergy. 2013 Oct;3(4):249-56. doi: 10.5415/apallergy.2013.3.4.249. Epub 2013 Oct 31.

Adverse events of intravenous immunoglobulin infusions: a ten-year retrospective study.

Asia Pacific allergy

Frances Rose R Palabrica, Shirley L Kwong, Florecita R Padua

PMID: 24260730 PMCID: PMC3826603 DOI: 10.5415/apallergy.2013.3.4.249

Abstract

BACKGROUND: Intravenous immunoglobulin (IVIG) is a biological product with adverse effects that appears to vary considerably among different IVIG preparations.

OBJECTIVES: To describe the adverse events of patients given intravenous immunoglobulin infusions.

METHOD: Data was collected on all patients receiving IVIG infusion at a tertiary hospital from January 2001 to December 2010. Descriptive statistics was used.

RESULTS: 77 patients (45 males, 32 females) received IVIG infusions. Thirty two percent (n = 25) experienced adverse reactions. The most common indication was Kawasaki disease (85.7%) followed by immunodeficiency disorders (7.8%). Majority of the patients were children, with the highest frequency of infusions among those aged 2 to 8 years old (52%). 36 infusions were associated with occurrence of adverse effects. Fever was the most common adverse event (n = 11, 30.6%), followed by rash (n = 8, 22.2%) and chills (n = 7, 19.4%). Other adverse events were cyanosis (n = 3, 8.3%), hypotension (n = 2, 5.6%), hypothermia (n = 2, 5.6%), irritability (n = 1, 2.8%), vomiting (n = 1, 2.8%), and chest pain (n = 1, 2.8%). Adverse events were observed to occur most frequently within 1 to 6 h from onset of IVIG infusion. Among the various IVIG preparations available locally (Gammagard, Kiovig, Gamimune, Veno-S & IV Globulin S), Gammagard was the brand frequently used (50.7%). It also has the most number of adverse events, with 17 out of 41 (41.5%) infusions resulting in adverse reactions. Most of the reactions occurred with fast infusion rates, and clinical manifestations subsided when the rate of infusion was reduced.

CONCLUSION: In this study, thirty two percent of patients given IVIG infusions experienced adverse events. Fever was the most common manifestation. Symptoms occurred within 1 to 6 h from onset of infusion, were affected by fast infusion rates, and managed by reducing the rate of infusion.

Keywords: Intravenous immunoglobulins; Retrospective study; Side effects

References

1. Neurology. 2002 Dec 24;59(12 Suppl 6):S28-32 - PubMed
2. Clin Exp Immunol. 1994 Jul;97 Suppl 1:79-83 - PubMed
3. J Investig Allergol Clin Immunol. 2009;19(2):139-45 - PubMed
4. Cochrane Database Syst Rev. 2002;(1):CD001090 - PubMed
5. Arch Dis Child. 2006 Aug;91(8):651-4 - PubMed
6. J Allergy Clin Immunol. 2011 Feb;127(2):315-23; quiz 324-5 - PubMed

Publication Types

• Journal Article