[Anaphylactic shock reaction following intravenous administration of 7S immunoglobulin in patients with hypogammaglobulinemia, especially in children with acute lymphoblastic leukemia (ALL)].
Severe anaphylactic reactions were observed in 2 children, aged 2 and 14 years, with acute lymphocytic leukemia and a 12 month old infant with a functional T-cell defect after intravenous administration of a polyethyleneglycol (PEG)-treated immunoglobulin preparation. All 3 children suffered additionally from hypogammaglobulinemia. Intravenous infusions of 7S-immunoglobulin preparations with a modification of the Fc portion, however, had been well tolerated by the same patients. Investigations of the immunoglobulin preparations revealed IgG aggregates (approximately 35%) in one batch of the PEG-treated immunoglobulin preparation. Prekallikrein activator and kallikrein were not increased in the immunoglobulin preparations tested. These results in addition to our clinical experiences suggest that only 7S-immunoglobulin preparations with a modification of the Fc portion should be used in patients with hypo- or a-gammaglobulinemia, in order to avoid complement activation released by the intact 7S-preparations.
D000293:Adolescent; D000361:Agammaglobulinemia / Q000276:immunology / Q000628:therapy*; D000707:Anaphylaxis / Q000276:immunology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D007136:Immunoglobulins / Q000378:metabolism; D016756:Immunoglobulins, Intravenous; D007262:Infusions, Intravenous; D007945:Leukemia, Lymphoid / Q000276:immunology / Q000628:therapy*; D008297:Male
D007074:Immunoglobulin G; D007136:Immunoglobulins; D016756:Immunoglobulins, Intravenous
Anaphylaktische Schockreaktion nach intravenöser Gabe von 7S-Immunglobulin bei Patienten mit Hypogammaglobulinämie, insbesondere bei Kindern mit akuter lymphoblastischer Leukämie (ALL).