Safety of intravenous immunoglobulin treatment.
BACKGROUND
Intravenous immunoglobulin (IVIg) is a biologic pharmaceutical that is widely used to treat immunodeficiency conditions and a variety of autoimmune conditions. It is under-recognized that IVIg can be associated with severe complications including death.


METHODS
This review will address common mild side effects and extensively discuss the uncommon but serious complications of IVIg. Mild constitutional reactions include headache, fever and rash and severe complications include anaphylaxis, acute renal failure, stroke and myocardial infarction. IVIg has been used to treat autoimmune illnesses for ~30 years and the literature since then is reviewed with special attention to reports in the last 10 years that detail the serious adverse events.


RESULTS
The reader will understand that mild side effects are common and that these can be ameliorated with pre-treatment medications. They will also become familiar with the risk factors for serious complications so that careful patient and IVIg product selection will result in fewer poor outcomes.


CONCLUSIONS
IVIg is quite safe across age groups although serious adverse reactions occur particularly in elderly individuals with multiple cardiovascular risk factors and those with preexisting renal failure.
Caress
James B
JB
Department of Neurology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA. jcaress@wfubmc.edu
Kennedy
Burton L
BL
Eickman
Kara D
KD
D001327:Autoimmune Diseases / Q000150:complications* / Q000188:drug therapy; D017074:Common Variable Immunodeficiency / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*
D016756:Immunoglobulins, Intravenous