Intravenous immunoglobulin in pediatrics: A review

Abstract

Agammaglobulinemia Autoimmune disorder a b s t r a c tThere has been a rapid expansion of the use of intravenous immunoglobulin (IVIG) for an ever-growing number of conditions. IVIG is used at a 'replacement dose' (400e600 mg/kg/ month) in antibody deficiencies and is used at a high dose (2 g/kg) as an 'immunomodulatory' agent in an increasing number of immune and inflammatory disorders.

Intravenous immunoglobulin therapy among pediatric patients: labeled and off-labeled indications

“…For all labeled indications, the recommended IVIG dose and frequency are according to the guidelines of the British Columbia IVIG Utilization Management Handbook and the Canadian Blood Service 2000 national consensus conference on IVIG. For off-labeled indications, IVIG was administered using a variety of dosing regimens but still following the usual recommended dose in labeled indications, which ranged from 0.4 g/kg to 2.0 g/kg per course in either a single dose or few divided doses (Prasad, Chaudhary, 2014).…”

“…Chronic inflammatory demyelinating polyneuropathy (CIDP) Appropriate use of IVIG was placed into one of three a priori agreed upon categories. Off-labeled indication is defined as the indication of IVIG other than the seven indications approved by the FDA (Prasad, Chaudhary, 2014). Off-labeled indication is further categorized into 2 subgroups, "potentially indicated" or "not indicated."…”

“…In pediatrics, IVIG has been found to have a major impact in the treatment of conditions in the fields of neurology, hematology, rheumatology, dermatology, neonatology, immunology, cardiology, and infectious diseases (Prasad, Chaudhary, 2014). More than 150 offlabeled indications of IVIG in 128 clinical trials and 268 case reports were reported in another literature review by Leong et al (2008).…”

Intravenous Immunoglobulin Replacement Therapy in Children with Primary Immunodeficiency Diseases: A Nurse's Guide

“…The rate of infusion is determined by ml/ kg per hour. Infusion rates are usually started at 0.01-0.02 ml/kg/min and increased up to 0.1 ml/kg/ min (23).…”

The use of intravenous immunoglobulin therapy in a tertiary pediatric hospital

“…[3][4][5] Although IVIGs are used at dosages of 400-500 mg/kg in replacement therapy, higher doses are used for immunoregulatory treatments. 1,6 Several early onset side effects of IVIG use have been observed, including fever, rash, headache, nausea, vomiting, and myalgia, as well as late onset and severe side effects, including aseptic meningitis, acute kidney failure, thromboembolic events, hemolytic anemia, and myocardial infarctions. Although the incidence of IVIG-related side effects differs among previous studies, it has been reported to range from 3-20%.…”