Adverse effects of intravenous immunoglobulin therapy in 56 patients with autoimmune diseases.
OBJECTIVE
To test the adverse effects and viral safety of intravenous immunoglobulin (IVIg) use in autoimmune diseases.


METHODS
Fifty-six patients with various autoimmune diseases who were treated with one to six IVIg courses were evaluated for the presence of adverse effects following IVIg therapy and were screened before and after the treatment for the presence of serum human immunodeficiency virus antibodies, hepatitis C virus antibodies, and hepatitis B surface antigen.


RESULTS
Among the 56 patients, 20 (36%) had at least one adverse effect following at least one of the treatment courses. These included headache, low-grade fever, chills, anemia, low-back pain, transient hypotension, nausea, intensified perspiration, and superficial and deep vein thromboses. Whereas the presence of adverse effect to IVIg was unrelated to either the clinical response to the treatment or to the nature of the autoimmune disease, the occurrence of an adverse effect in the first treatment course was significantly associated with a greater chance for an adverse effect in the subsequent courses. No transmission of any of the three viral agents examined could be detected.


CONCLUSIONS
Although IVIg use in autoimmune diseases is associated with adverse effects in about one third of the patients, these effects are usually mild and transient. Patients who develop adverse effects during the first treatment course may be at increased risk of adverse effects during the subsequent IVIg courses.
Sherer
Y
Y
Department of Medicine 'B' and Research Unit of Autoimmune Diseases, Sheba Medical Center, Tel Hashomer 52621, Israel.
Levy
Y
Y
Langevitz
P
P
Rauova
L
L
Fabrizzi
F
F
Shoenfeld
Y
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects* / Q000627:therapeutic use; D007223:Infant; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014777:Virus Diseases / Q000635:transmission*
D015483:HIV Antibodies; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies; D016756:Immunoglobulins, Intravenous