title: Safety of intravenous immunoglobulin in the elderly treated for a dysimmune neuromuscular disease.
abstract: BACKGROUND
  Many patients treated with intravenous immunoglobulin (IVIg) are >60 years of age. Tolerability has yet to be demonstrated in this age group.
  
  
  METHODS
  This is a retrospective study of adverse reactions among consecutive patients treated with IVIg for neurological disorders. Risk factors were recorded. Correlation and relative risks were calculated for age, risk factors, IVIg course, daily dose, concentration, preparation, and duration of treatment. An infusion and monitoring protocol was applied.
  
  
  RESULTS
  Two hundred forty-four patients were reviewed, including 62% who were ≥60 years of age (total dose 1.8 ± 0.4 g/kg body weight, daily dose 30.3 ± 2.0 g). Sixty-nine percent received sugar-stabilized IVIg. Forty-nine percent presented with >1 risk factor. Adverse reactions occurred in 35% and led to treatment discontinuation in 5%, with a similar incidence among age groups. In patients ≥60 years old, sucrose-free IVIg administration was an independent predictor of adverse reactions, including renal failure.
  
  
  CONCLUSIONS
  In the elderly, IVIg infusions are safe. Adverse reactions mainly depend on IVIg preparation and administration. Renal failure is not uncommon with sugar-free IVIg.
authors.affiliation: French National Referral Centre for Familial Amyloid Polyneuropathy and Other Rare Peripheral Neuropathies, NNERF, Le Kremlin Bicêtre, France, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Lozeron
authors.affiliation: French National Referral Centre for Familial Amyloid Polyneuropathy and Other Rare Peripheral Neuropathies, NNERF, Le Kremlin Bicêtre, France, France.
authors.forename: Adeline
authors.initials: A
authors.lastname: Not
authors.affiliation: French National Referral Centre for Familial Amyloid Polyneuropathy and Other Rare Peripheral Neuropathies, NNERF, Le Kremlin Bicêtre, France, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Theaudin
authors.affiliation: French National Referral Centre for Familial Amyloid Polyneuropathy and Other Rare Peripheral Neuropathies, NNERF, Le Kremlin Bicêtre, France, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Denier
authors.affiliation: French National Referral Centre for Familial Amyloid Polyneuropathy and Other Rare Peripheral Neuropathies, NNERF, Le Kremlin Bicêtre, France, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Masnou
authors.affiliation: French National Referral Centre for Familial Amyloid Polyneuropathy and Other Rare Peripheral Neuropathies, NNERF, Le Kremlin Bicêtre, France, France.
authors.forename: Mariana
authors.initials: M
authors.lastname: Sarov
authors.affiliation: French National Referral Centre for Familial Amyloid Polyneuropathy and Other Rare Peripheral Neuropathies, NNERF, Le Kremlin Bicêtre, France, France.
authors.forename: Clovis
authors.initials: C
authors.lastname: Adam
authors.affiliation: French National Referral Centre for Familial Amyloid Polyneuropathy and Other Rare Peripheral Neuropathies, NNERF, Le Kremlin Bicêtre, France, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Cauquil
authors.affiliation: French National Referral Centre for Familial Amyloid Polyneuropathy and Other Rare Peripheral Neuropathies, NNERF, Le Kremlin Bicêtre, France, France.
authors.forename: David
authors.initials: D
authors.lastname: Adams
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D003875:Drug Eruptions / Q000209:etiology; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D005260:Female; D020275:Guillain-Barre Syndrome / Q000188:drug therapy / Q000453:epidemiology; D006261:Headache / Q000139:chemically induced*; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000453:epidemiology; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects* / Q000627:therapeutic use; D007155:Immunologic Factors / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000188:drug therapy / Q000453:epidemiology; D009468:Neuromuscular Diseases / Q000188:drug therapy* / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology; D010265:Paraproteinemias / Q000453:epidemiology; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy / Q000453:epidemiology; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000188:drug therapy / Q000453:epidemiology; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D020246:Venous Thrombosis / Q000453:epidemiology; D055815:Young Adult
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors
keywords: CIDP; dose; elderly; intravenous immunoglobulin; side effect; sucrose