A review of current indications, adverse effects, and administration recommendations for intravenous immunoglobulin.
OBJECTIVE
To review and summarize the body of literature regarding human intravenous immunoglobulin (hIVIG) therapy in veterinary medicine. Mechanism of action, usage in human medicine, adverse effects of therapy, implications for veterinary use, and administration recommendations are discussed.


METHODS
Current human and veterinary peer-reviewed medical literature including original research articles and scientific reviews.


RESULTS
There are currently 6 labeled uses for hIVIG in human medicine, but preparations are used off-label to successfully treat multiple immune-mediated conditions. To maximize the potential of hIVIG use in animals and identify areas deficient in research, a review of the current literature is warranted.


RESULTS
Investigation of hIVIG therapy in veterinary patients has been limited to the subjects of immune-mediated hemolytic anemia (IMHA), immune-mediated thrombocytopenia (ITP), Evan's syndrome, cutaneous disease, myasthenia gravis (MG), and sudden acquired retinal degeneration (SARDS). Proponents of veterinary hIVIG use believe administration may reduce transfusion requirements and decrease hospitalization time.


CONCLUSIONS
Immunoglobulin (Ig) has not been shown to decrease transfusion requirements in IMHA patients, but shows great promise for treatment of ITP and dermatological diseases. Although serial transfusion of hIVIG is employed in human medicine, repeated transfusion is not recommended in animals due to risk of severe allergic reaction. Other potential adverse effects of transfusion include delayed hypersensitivity reactions, thromboembolism, renal failure, hypotension, and aseptic meningitis.
Department of Emergency and Critical Care, The Animal Medical Center, New York, NY 10065, USA. nicole.spurlock@amcny.org
Nicole K
NK
Spurlock
Jennifer E
JE
Prittie
D000744:Anemia, Hemolytic, Autoimmune / Q000628:therapy / Q000662:veterinary; D000818:Animals; D001787:Blood Group Incompatibility / Q000662:veterinary*; D002371:Cat Diseases / Q000628:therapy; D002415:Cats; D004283:Dog Diseases / Q000628:therapy*; D004285:Dogs; D004892:Erythema Multiforme / Q000662:veterinary; D006801:Humans; D007136:Immunoglobulins; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D007262:Infusions, Intravenous / Q000662:veterinary
D007136:Immunoglobulins; D016756:Immunoglobulins, Intravenous