Acute Hemolysis in a Patient with Cytomegalovirus Pneumonitis Treated with Intravenous Immunoglobulin (IVIG)

Coghill, James M.; Comeau, Terrance; Shea, Thomas C.; Braddy, Linda; Bandarenko, Nicholas; Afenyi‐Annan, Araba; Harvey, Donald

doi:10.1016/j.bbmt.2006.03.003

Cited by 15 publications

(17 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We decided a priori to retain age and sex in the final models, regardless of their significance, as both are important biologic and clinical risk factors. The 10% change-in-estimate strategy and likelihood ratio test were used to determine additional covariates to include in the final multivariable regression models from the comprehensive list of potential risk factors (e.g., underlying health conditions, 30 Elixhauser comorbidities, approved uses, off-label uses, number of IG administrations). Hence, the final multivariable regression models adjusted for likely confounders and ascertained potential risk factors of IG-related hemolysis.…”

Section: Discussionmentioning

confidence: 99%

“…1,3,4,7,16 Correspondingly, there have been an increasing number of reports of IG-related hemolysis, which have resulted in the United States' and Canada's warnings on IG-related safety as well as in a Food and Drug Administration (FDA)-cosponsored workshop on risks of IG-related hemolysis. [22][23][24][25][26][27] As current literature on IG-related hemolysis is mostly based on case reports, 15,17,[28][29][30][31][32][33][34][35][36][37][38][39] and population-based incidence and recipient risk factors (e.g., demographic characteristics, underlying health conditions) have not been established, we conducted a large retrospective population-based study to assess occurrence of same-day hemolysis for different US-licensed IG products and to ascertain potential risk factors, during the 2008 to 2014 study period.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Occurrence of hemolytic reactions on the same day as immune globulin product administrations during 2008 to 2014

Sridhar¹,

Ekezue²,

Izurieta

et al. 2017

Transfusion

View full text Add to dashboard Cite

BACKGROUND Hemolytic reactions (HRs) are rare serious adverse events after immune globulin (IG) use. Our large claims‐based study evaluated occurrence of same‐day hemolysis after administration of different IG products and potential risk factors, during the 2008 to 2014 study period. STUDY DESIGN AND METHODS We conducted a retrospective cohort study using a large commercial administrative database. The study included individuals exposed to IG products as identified by procedure codes. HRs were ascertained using ICD‐9‐CM diagnosis codes. Unadjusted same‐day hemolysis rates (per 1000 persons) were estimated overall, by age, sex, and IG products. Multivariable regression analyses were used to evaluate potential risk factors. RESULTS Of 20,440 persons exposed, 211 (10.3 per 1000) had same‐day HRs. The median numbers of doses for IG users with versus without same‐day hemolysis were one and six, respectively. The unadjusted product‐specific HR rates ranged from 1.92 for subcutaneous product Hizentra to 17.99 for intravenous Octagam. The multivariable regression analyses showed significantly increased same‐day HR risk in males and in IG users with histories of hemolysis, pneumonia, and hereditary hemolytic anemias. Compared to Gammagard Liquid, significantly elevated overall hemolysis risk was identified with Octagam (odds ratio, 2.36; 95% confidence interval, 1.04‐5.35), using Firth's method to account for small sample size bias. CONCLUSION The study showed variation in the same‐day IG‐related hemolysis by age, sex, and IG products administered. The results suggest importance of underlying health conditions, especially prior hemolysis, and first IG product dose. Differences in HR occurrence may also be explained by product manufacturing processes, indications, routes, and rates of administration, which warrant further investigation.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Occurrence of hemolytic reactions on the same day as immune globulin product administrations during 2008 to 2014

Sridhar¹,

Ekezue²,

Izurieta

et al. 2017

Transfusion

View full text Add to dashboard Cite

show abstract

“…There are scattered case reports describing this phenomenon, but it has not yet been described in ESRD patients on dialysis (1,(10)(11)(12)(13)(14)(15). One recent report describes the development of acute kidney injury related to hemoglobinuria as a result of IH (16).…”

mentioning

confidence: 99%

Acute Hemolysis After High-Dose Intravenous Immunoglobulin Therapy in Highly HLA Sensitized Patients

Kahwaji

Barker²,

Pepkowitz

et al. 2009

Clinical Journal of the American Society of Nephrology

120

122

View full text Add to dashboard Cite

“…Despite this, there are few reported cases of acute hemolysis due to anti-A/B antibodies after IVIG infusions [41]. However, in our highly HLA-sensitized ESRD, we have noticed several episodes of acute hemolysis following IVIG infusions on dialysis.…”

Section: Ig and Hemolytic Anemiamentioning

confidence: 88%

Therapeutic Strategies in Management of the Highly HLA-Sensitized and ABO-Incompatible Transplant Recipients

Jordan¹,

Peng²,

Vo³

2008

Contributions to Nephrology

View full text Add to dashboard Cite

Intravenous immunoglobulin (IVIG) products are derived from pooled human plasma and have been used for the treatment of primary immunodeficiency disorders for more than 24 years. Shortly after their introduction, IVIG products were found to be effective in the treatment of autoimmune and inflammatory disorders. Rituximab (anti-CD20, anti-B-cell monoclonal antibody) has also shown efficacy in the treatment of autoimmune and inflammatory disorders. We have recently described a beneficial effect of the combination of IVIG + rituximab on the reduction of anti-human leukocyte antigen (HLA) antibodies with subsequent improvement in rates of transplantation for highly HLA-sensitized patients as well as a potent anti-inflammatory effect that is beneficial in the treatment of antibody-mediated rejection. These advancements have enabled patients previously considered poor or unreasonable candidates for transplantation to receive a successful transplant. Alternative approaches to IVIG/rituximab-based desensitization include the addition of plasmapheresis and possible splenectomy. Furthermore, new advancements in detecting donor-specific anti-body and assessment of antibody-mediated injury to allografts (C4d staining) allow for early detection of antibody-mediated rejection and early implementation of IVIG/rituximab therapy to prevent allograft loss.

show abstract

Acute Hemolysis in a Patient with Cytomegalovirus Pneumonitis Treated with Intravenous Immunoglobulin (IVIG)

Cited by 15 publications

References 5 publications

Occurrence of hemolytic reactions on the same day as immune globulin product administrations during 2008 to 2014

Occurrence of hemolytic reactions on the same day as immune globulin product administrations during 2008 to 2014

Acute Hemolysis After High-Dose Intravenous Immunoglobulin Therapy in Highly HLA Sensitized Patients

Therapeutic Strategies in Management of the Highly HLA-Sensitized and ABO-Incompatible Transplant Recipients

Contact Info

Product

Resources

About