Immunoglobulins and Their Use in Children

Abstract

Immunoglobulin preparations are one of the products of the human plasma fractionation, where the plasma is obtained, in accordance with WHO guidelines from at least 1,000 donors. These preparations contain all IgG subclasses with various antigen characteristics. In clinical practice these drugs are used as replacement therapy in patients with primary and secondary immunodeficiencies as well as immunomodulatory therapy in many autoimmune diseases and systemic inflammatory diseases. Here we present characteristics of i.v. polyvalent, human immunoglobulin preparations available on the Polish market and the possibilities of their use in clinical practice, in children with hematological diseases. Considering the very low consumption of immunoglobulin preparations in our country as compared to other European countries, we would like to draw the attention of medical professionals, especially pediatricians and haematologists, to the benefits that stem from the use of these drugs in the therapy of children with haematological diseases. Our work will also facilitate the choice of an optimal polyvalent human immunoglobulin preparation for a particular patient (Adv Clin Exp Med 2015, 24, 1, 153-159).

Efficacy and safety of human intravenous immunoglobulin 5% (Ig VENA) in pediatric patients affected by primary immunodeficiency

“…For more than 20 years, immunoglobulins are widely used as a modulatory factor in the treatment of autoimmune and inflammatory diseases that represent a common finding in primary immunodeficiecies. 23 , 24 Patient 01 was affected by Evans syndrome in the context of 22q11 deletion. IVIg, even through at replacement dose (400 mg/kg/28 days) improved his clinical disease course.…”

Immediate adverse reactions to intravenous immunoglobulin in primary immune deficiencies: a single center experience

“…The mean frequency of AE seen during IVIG treatment was reported to be 20% changing from 1 to 81%. [7][8][9][10] Galli et al 19 reported 40% of AE seen in PID children. In addition, Dashti-Khavidaki et al 20 documented 216 AE (7.2%) in 3,004 infusions for 13 years.…”

“…[2][3][4][5][6] The frequency of adverse events seen in IVIG treatment varies between 1-81% with a mean value of 20%. [7][8][9][10] These are classified as early or late according to the time of occurrence of the reaction. 11 The most common early adverse events (AE) are fever, chills, headache, nausea, hypotension, myalgia, wheezing, back pain and rash.…”

“…During the production process, ethanol precipitation or stabilizer addition may generate immunoglobulin aggregates resulting in AE. 7,8 Primary antibody deficient patients with very low levels of IgA are predisposed for reactions during IVIG treatment due to anti IgA antibodies which could be managed by the use of products containing trace amount of IgA. 12 Moreover, rapid rate especially at the initial phase of the infusion, presence of an acute infection, osmolality of the product, sodium and sugar contents and pH value may also be related to adverse reactions.…”