Anti-IgA antibody associated reactions to intravenous gammaglobulin in a patient who tolerated intramuscular gammaglobulin.
A patient with common variable immunodeficiency syndrome tolerated intramuscular IgG (which contains IgA) and an initial infusion with intravenous (IV) IgG, but developed reactions to subsequent IV IgG. High-titre, class-specific anti-IgA antibodies were detected suggesting immunization by the IgA-contaminated IV immunoglobulin. Subsequent IgG replacement was achieved with IgA-deficient plasma infusions. Patients who tolerate intramuscular IgG may not tolerate the IV preparations.
S J
SJ
Frankel
S H
SH
Polmar
F C
FC
Grumet
H J
HJ
Wedner
D000888:Antibodies, Anti-Idiotypic / Q000276:immunology*; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology*; D007153:Immunologic Deficiency Syndromes / Q000188:drug therapy; D007273:Injections, Intramuscular; D007275:Injections, Intravenous / Q000009:adverse effects; D008875:Middle Aged; D005719:gamma-Globulins / Q000008:administration & dosage* / Q000627:therapeutic use
D000888:Antibodies, Anti-Idiotypic; D007070:Immunoglobulin A; D005719:gamma-Globulins