Haemolysis induced by intravenously‐administered immunoglobulin

Possible mechanisms for intravenous immunoglobulin–associated hemolysis: clues obtained from review of clinical case reports

“…[3][4][5][6][7][8] Table S2 summarizes pediatric cases of non-O blood group with possible IVIG-associated hemolysis. 22,[34][35][36][37][38][39][40][41][42][43] Table S3 summarizes cases with blood group O and/or case reports with possible IVIG-associated hemolysis attributed to anti-D. 4,10,12,16 Table S4 summarizes cases with possible IVIG-associated hemolysis of unknown blood group, and with DAT not performed or if positive, no eluate results provided. 26,30,[44][45][46] Of the 97 adult non-O blood group cases (>16 years of age), 71 (73%) were in blood group A patients (one adult case presumed to be blood group A with anti-A identified in the eluate), 10 (10%) blood group B, and 16 (16%) blood group AB.…”

Intravenous immune globulins: an update for clinicians

“…[173][174][175] In one study of patients treated with IVIG after BMT, 49 percent of recipients developed positive DATs, and 25 percent had positive antibody screens, most often due to passively transfused anti-A, -B, -D, and -K. 173 However, examples have been reported of hemolytic anemias due to anti-D or anti-A. 172,[175][176][177] This hemolysis presumably occurs because of direct antibody attack on RBCs; one group also reports that binding of IgG dimers and aggregates to CR1 (CD35) on RBCs can enhance extravascular reticuloendothelial system (RES) removal. 178 ABO and Rh antibodies might be expected to be advantageous in treating ITP in patients with relevant blood groups in that RBC destruction could contribute to reticuloendothelial blockade.…”

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

“…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 .…”