Adverse reactions of prophylactic intravenous immunoglobulin infusions in Iranian patients with primary immunodeficiency.
BACKGROUND
Although long-term intravenous immunoglobulin infusion is an effective treatment for children with antibody deficiencies, it can be complicated by systemic adverse reactions.


OBJECTIVE
To evaluate the adverse reactions of intravenous immunoglobulin therapy in patients with primary immunodeficiency.


METHODS
Seventy-one immunodeficient patients receiving intravenous immunoglobulin were evaluated during a 7-year period (1995-2002) at Children's Medical Center in Tehran, Iran. Immunological diagnoses were as follows: common variable immunodeficiency (31 patients), X-linked agammaglobulinemia (25 patients), IgG subclass deficiency (5 patients), hyper-IgM syndrome (2 patients), and ataxia-telangiectasia (8 patients).


RESULTS
One hundred fifty-two cases (12.35%) of adverse reactions occurred following 1,231 infusions in 35 patients. The most frequent immediate adverse reactions were mild reactions (131 infusions), including chills, fever, flushing, muscle pains, nausea, headache, and anxiety. Moderate reactions, such as vomiting, chest pain, and wheezing, occurred in 19 infusions. Two patients experienced severe adverse reactions. The highest proportion (23.06%) of reaction to injection was in patients with common variable immunodeficiency.


CONCLUSIONS
Intravenous immunoglobulin is a well tolerated medical agent for patients with antibody deficiency. However, to prevent occurrence of immediate adverse reactions during infusion in these patients, physicians should perform a detailed history and proper physical examination and check the titer of anti-IgA.
Aghamohammadi
Asghar
A
Department of Allergy and Clinical Immunology of Children's Medical Center, Immunology Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Farhoudi
Abolhasan
A
Nikzad
Mohsen
M
Moin
Mostafa
M
Pourpak
Zahra
Z
Rezaei
Nima
N
Gharagozlou
Mohammad
M
Movahedi
Masoud
M
Atarod
Lida
L
Afshar
Akefeh Ahmadi
AA
Bazargan
Nasrin
N
Hosseinpoor
Ahmad Reza
AR
D000293:Adolescent; D000328:Adult; D000361:Agammaglobulinemia / Q000628:therapy; D001260:Ataxia Telangiectasia / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D017074:Common Variable Immunodeficiency / Q000628:therapy; D005260:Female; D006801:Humans; D017099:IgG Deficiency / Q000628:therapy; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects* / Q000627:therapeutic use; D007153:Immunologic Deficiency Syndromes / Q000628:therapy*; D007492:Iran; D008137:Longitudinal Studies; D008297:Male; D012189:Retrospective Studies
D016756:Immunoglobulins, Intravenous