title: Effect of high-dose intravenous immunoglobulin on serum chemistry, hematology, and lymphocyte subpopulations: assessments based on controlled treatment trials in patients with neurological diseases.
abstract: The effect of intravenous immunoglobulin (IVIG) on various laboratory values was measured immediately before and after completion of serial monthly infusions of IVIG (2 g/kg) or an equal volume of placebo over 3-12 months, in 46 patients with neuromuscular diseases participating in controlled trials. Hematological, lymphocyte subpopulation, and chemistry values were analyzed and compared. After IVIG, but not placebo, a 34% reduction in lymphocytes was noted in 44/46 patients with a selective reduction of the T cells, but not the B or IL2R-positive cells. Counts returned to baseline within 30 days. Creatine kinase levels decreased by 23% and sedimentation rate increased by 275% after IVIG infusion. A nondilutional, artifactual, hyponatremia and hypomagnesemia was noted with IVIG but not placebo. We conclude that IVIG affects a variety of serum chemistry and hematological values either directly or artifactually by interfering with the laboratory method used for the assays. Transient lymphopenia is consistently seen, and may play a role in the immunomodulating effect of IVIG.
authors.affiliation: Neuromuscular Diseases Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD 20892-1382, USA.
authors.forename: B M
authors.initials: BM
authors.lastname: Koffman
authors.forename: M C
authors.initials: MC
authors.lastname: Dalakas
mesh_terms: D000328:Adult; D001769:Blood / Q000378:metabolism*; D001773:Blood Cells / Q000502:physiology*; D001799:Blood Sedimentation; D002648:Child; D002986:Clinical Trials as Topic; D004305:Dose-Response Relationship, Drug; D006801:Humans; D016756:Immunoglobulins, Intravenous; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets / Q000473:pathology*; D009468:Neuromuscular Diseases / Q000097:blood / Q000473:pathology* / Q000628:therapy*; D012189:Retrospective Studies
chemical_list: D016756:Immunoglobulins, Intravenous