Adverse reactions of intravenous immunoglobulin

OBJECTIVE: To study the frequency, type, and severity of adverse reactions to intravenous immunoglobulin infusions and possible preventable measures.

METHODS: We prospectively studied the frequency, type, and severity of adverse reactions in 104 intravenous immunoglobulin infusions (IntraglobinTMF) given to 13 patients suffering from several immunodeficiency and autoimmune diseases over 15 months in King Hussein Medical Center. The severity of the reaction was classified as mild, moderate and severe. Transmission of infections such as human immunodeficiency virus, hepatitis B, and C was monitored.

RESULTS: The total number of reactions documented was 16 out of 104 (14.5%) infusions and all resolved without medical aid. Excluding those reactions in which a predisposing factor was identified, the overall rate was 6%.

CONCLUSION: This study has shown that the overall reaction rate in patients infused with intravenous immunoglobulin at hospital is low. However, establishment of specialized staff will decrease the adverse reactions considerably. We advise the care-taking staff to elicit the predisposing factors like infection and avoid infusion until antibiotics have been started for 24-48 hours. We found that strict application of manufacturer infusion protocols (IntraglobinTMF) will avoid reactions due to accelerating rate of infusion. Intravenous immunoglobulin is a useful life saving drug. It is safe if all precautions are taken into consideration.