Complications of intravenous gammaglobulin in neuromuscular and other diseases

Bertorini, Tulio E.; Nance, Adriana M.; Horner, Linda H.; Greene, William H.; Gelfand, Mikhail S.; Jaster, J. Howard

doi:10.1002/(sici)1097-4598(199603)19:3<388::aid-mus20>3.3.co;2-y

Cited by 7 publications

(7 citation statements)

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“…In particular, the likelihood of ARs to IVIG correlated with having neuromuscular diseases (odds: 6.914) among patients with any autoimmune disease. In fact, in that subgroup, the incidence of ARs for neuromuscular diseases was 28.4% (data not shown), consistent with other studies ( 12 , 14 , 21 ) that have reported ARs in more than 20% of patients with neuromuscular diseases. Wietek et al ( 22 ) analyzed data from 112 patients with ITP receiving IVIG, in which there were five cases with at least one AR.…”

Section: Discussionsupporting

confidence: 91%

“…In addition, the IVIG doses for patients with autoimmune diseases were higher than for those with non-autoimmune diseases. Furthermore, the present and previous studies ( 14 , 17 ) have reported that the mean course doses per bodyweight (g/kg) for patients with ARs (1.9 g/kg) were significantly higher than for patients without ARs (1.1 g/kg) (p < 0.001) (data not shown). The mean course dose per bodyweight of IVIG for autoimmune diseases (1.76 g/kg) was higher than those for non-autoimmune diseases (0.25 g/kg) excepting other conditions (0.98 g/kg).…”

Section: Discussionsupporting

confidence: 43%

“…Although a large number of clinical trials have demonstrated that IVIG is generally safe and well tolerated, various ARs do occur. The reported incidence of ARs varies widely, from 1% to more than 50% of patients, depending on the study ( 10 – 14 ). ARs are rare among immunodeficient patients when receiving the same dose as previously well tolerated at regular intervals.…”

Section: Discussionmentioning

confidence: 99%

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A Retrospective Observational Study of Adverse Reactions Associated With Intravenous Immunoglobulin Infusion

et al. 2021

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BackgroundAlthough intravenous immunoglobulin (IVIG) therapy is generally safe and well tolerated, adverse reactions (ARs) do occur. The majority of these ARs are mild and transient. Risk factors for ARs associate with IVIG infusions are not well established. This study investigated possible risk factors influencing the occurrence of IVIG-associated ARs.Study Design and MethodsThis was a retrospective observational analysis of data accumulated over 5 years, including patient demographics, clinical condition, IVIG dosing regimens, number of IVIG infusions, and any ARs.ResultsARs were associated with IVIG in 4.9% of patients and 2.5% of infusions. By univariate analyses, ARs correlated with female sex, adult age, high dose IVIG, and autoimmune disease. Multivariate logistic regression identified three statistically significant of risk factors: on a per-patient basis, being female (p=0.0018), having neuromuscular disease (p=0.0002), and receiving higher doses of IVIG per patient body weight (p<0.001), on a per-infusion basis, being female (p < 0.001), being adolescents to middle age (p < 0.001), and having neuromuscular disease (p < 0.001).ConclusionNeuromuscular disease emerged as one of the significant factors for ARs to IVIG.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 43%

Section: Discussionmentioning

confidence: 99%

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A Retrospective Observational Study of Adverse Reactions Associated With Intravenous Immunoglobulin Infusion

et al. 2021

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“…More serious adverse events can include aseptic meningitis, hypertension, cardiac arrhythmia, thrombocytopenia, and thrombotic events, including stroke, myocardial infarction, and pulmonary embolism. 47,48 For PE, 5 exchanges (1 plasma volume or 3-4 L per exchange) are usually performed every other day over 10 days. 13,49 Replacement fluid is generally a solution of normal saline/5% albumin.…”

Section: Treatment Of Myasthenic Crisismentioning

confidence: 99%

Myasthenic Crisis

Wendell

Levine²

2011

The Neurohospitalist

193

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Myasthenic crisis is a complication of myasthenia gravis characterized by worsening of muscle weakness, resulting in respiratory failure that requires intubation and mechanical ventilation. Advances in critical care have improved the mortality rate associated with myasthenic crisis. This article reviews the epidemiology of myasthenic crisis and discusses patient evaluation. Therapeutic options including mechanical ventilation and pharmacological and surgical treatments are also discussed.

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“…Adverse events occur in 1% to 15% of patients who receive IVIg regardless of whether they are receiving treatment in an inpatient or outpatient setting; in some studies, AEs have been reported in more than 50% of patients. Advanced patient age, preexisting renal failure, diabetes, and the use of sucrose as a stabilizing agent are associated with higher rates of IVIg infusion‐related complications . Vascular disease, paraproteinemia, and other causes of increased serum viscosity are associated with an increased risk of thromboembolism with IVIg treatment .…”

Section: Introductionmentioning

confidence: 99%

Safety of intravenous immune globulin in an outpatient setting for patients with neuromuscular disease

Waheed

Ayer²,

Jadoo³

et al. 2019

Muscle and Nerve

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Introduction Although intravenous immune globulin (IVIg) is used to treat patients in the outpatient setting, there is limited documentation addressing the safety of this practice. Methods Retrospective analysis of 438 patients with neuromuscular diseases receiving IVIg in an outpatient setting. Results Adverse events (AE) overall occurred in 16.9% of patients. Headache was the most common AE, noted in 11.6% of patients. Serious AEs occurred in 0.91% of patients; aseptic meningitis was the only one noted. Multivariate analyses identified the following risk factors for AEs: first‐lifetime course of IVIg, higher dose per course of IVIg, diagnosis of myasthenia gravis, women, and younger age. Discussion Intravenous immune globulin is generally safe to administer in an outpatient setting. Women, myasthenia gravis patients, and those receiving their first course or a higher total dose of IVIg are at an increased risk of experiencing an AE.

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Complications of intravenous gammaglobulin in neuromuscular and other diseases

Cited by 7 publications

References 0 publications

A Retrospective Observational Study of Adverse Reactions Associated With Intravenous Immunoglobulin Infusion

A Retrospective Observational Study of Adverse Reactions Associated With Intravenous Immunoglobulin Infusion

Myasthenic Crisis

Safety of intravenous immune globulin in an outpatient setting for patients with neuromuscular disease

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