IVIg (Intravenous Infusion of Immunoglobulins)
IVIG is a solution of globulins containing antibodies
normally present in adult human blood. Globulins are simple proteins that
provide immunity against disease. A protein is made up of several amino acids,
which are the microscopic building blocks that make up all cells. IVIG is used
as a temporary treatment to elevate platelet counts. Administration every 10 to
21 days is usually required to maintain adequate platelet counts. Response to
treatment is usually seen in 8 days.
Each batch of IVIg is made of human plasma derived from pools of 3,000 to
10,000 donors. Because this product is developed from pooled blood samples of
many different donors, it is theoretically possible that viruses or bacteria
could be transmitted in the product. Since 1985, however, all products are
tested for HIV and hepatitis. Immune Globulin comes in sterile solution and is
administered intravenously. It is made in different strengths and sizes.
Dosage
The therapeutic dose of IVIg is set at 2 g/kg. Although some practitioners
divide the total dose for infusion into five daily doses of 400 mg/kg each, it
may be preferable to divide the total dose into two daily doses of 1 g/kg each,
provided that the patient does not have such underlying conditions as congestive
heart failure or renal (kidney) insufficiency.
Cost
The cost for immunoglobulin has increased dramatically in the last few years.
The cost varies with the supplier and the delivery setting. You can
receive IVIg infusions in a hospital, doctor's office or at home.
Side Effects
In general, adverse reactions to IVIg therapy are usually minor and occur in
no more than 10% of patients. Mild-to-moderate headache, which responds to
nonsteroidal anti-inflammatory drugs, is common. Chills, chest discomfort may
develop in the first hour of the infusion and usually respond to cessation of
the infusion for 30 minutes and resumption of it at a slower rate. Fatigue,
fever, or nausea may occur after infusion and may last as long as 24 hours.
Other side effects include, dizziness, leg cramps, muscle aches and pains and
pain and tenderness at the injection site. Side effects that should be reported
to a health care provider includes, difficulty breathing, shortness of breath,
wheezing, chest pain or tightness, seizures or convulsions. A severe
anaphylactic reaction may occur in patients who have a serious deficiency of IgA
associated with anti-IgE or anti-IgG antibodies against IgA, which react with
the IgA in the IGG preparation. The reaction is rare occurring in about 1 out of
1000 people.
Related Web Sites
General IVIg information from Bayer
Baxter - Gammagard and Iveegam
IgG America - Home Infusion Service
http://www.ssem.com/gammagard/settlement/notice/gammagard.html
http://text.nlm.nih.gov/nih/cdc/www/80txt.html
http://www.scid.net/other.html
The SCID Home Page (Severe Combined Immunodeficiency)
|
