Behavior abnormality following intravenous immunoglobulin treatment in patients with primary antibody deficiencies.
OBJECTIVE
Treatment with intravenous immunoglobulin (IVIG) is considered a safe therapy for patients with primary antibody deficiencies (PADs), whilst adverse effects have been frequently reported. Meantime behavioral disorders reactions have not been reported yet. In this study, we describe for the first time a group of patients with PADs, who were under IVIG therapy and experienced some behavioral disorders.


METHODS
Five patients, including two hyper IgM syndromes, one X-linked agammaglobulinemia, one common variable immunodeficiency, and one hypo IgM disease, were surveyed. Analysis of Conner's Parents Rating Scales-Revised Short (CPRS-R:S) and child behavior checklist (CBCL) was performed for the patients, suspected to hyperactivity.


RESULTS
Analysis of CPRS-R:S showed an evidence of mild hyperactivity before IVIG administration in four patients, whereas another patient had evidence of severe hyperactivity. After IVIG administration, hyperactivity scores of three patients were changed from mild hyperactive behavior to markedly hyperactive behavior or attention deficit hyperactivity disorder range of hyperactivity. In the CBCL scores, there were abnormal externalization scores for three patients; while two remaining patients had abnormal internalization scores.


CONCLUSIONS
Although predisposition to behavioral disorders can be due to a genetic background, further investigations are necessary to test the hypotheses about responsibility of either IVIG or underling disease in progression of behavioral abnormalities.
Saroukhani
Sepide
S
Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Aghamohammadi
Asghar
A
Mahmoudi-Gharaei
Javad
J
Abolhassani
Hassan
H
Cheraghi
Taher
T
Imanzaeh
Amir
A
Moazzami
Kasra
K
Parvaneh
Nima
N
Rezaei
Nima
N
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000209:etiology; D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects* / Q000627:therapeutic use; D007153:Immunologic Deficiency Syndromes / Q000150:complications / Q000188:drug therapy*; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index
D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors