Primary immunodeficiency diseases that involve the immune system are many in number. These are characterized by impaired antibody function or lack of proper antibody function. Wiskott Aldrich Syndrome, Common Variable Immune Deficiency (CVID), Hyper-IgM Syndromes, X-Linked Agammaglobulinemia (XLA) etc. are some of the common immune system illnesses. However, over the past few years, the Immunoglobulin therapy has gained much momentum. It is a therapy that involves administration of immunoglobulin or antibody mixtures through the intravenous channels to treat these illnesses. The intravenous administration of immune globulins is highly effective most of the times to treat and build immunity in a person; however, at times it can have certain side effects which must be noticed and treated.

What is Intravenous Immune Globulins?

What is Intravenous Immune Globulins?

Intravenous Immune Globulins are associated with the immunoglobulin or antibody available in the human body. The blood plasma or serum contains these immunoglobulin or antibodies such as IgG, IgM, IgA, IgD and IgE. In the above mentioned illnesses, the production of these antibodies is impaired. Hence, individuals suffering from the illnesses require a replacement therapy to treat these illnesses.

Intravenous Immunoglobulin is a sterilized solution that is a mixture of the immunoglobulin or antibody and is given through the intravenous routes. In the Intravenous Immunoglobulin therapy, the IgG immunoglobulin is collected from many blood donors and then given intravenously to the patients. These antibodies help the body to prevent various diseases and infections.

The Intravenous Immunoglobulin cannot be replicated in the laboratory and therefore, there are no generic forms of this solution. To make one dose of Intravenous Immune Globulins, more than thousands of donors are needed. Their blood plasma is collected and then treated, so that the potential viral contaminations are deactivated. By treating the blood plasma, the maximum amount of IgG is ensured, reducing all other plasma contents.

Intravenous immune globulins have varied advantages for various diseases when given properly. However, many a times a person might develop certain side effects post the administration of intravenous immune globulins. For some these side effects can be mild, for others these can be serious requiring immediate medical attention. Hence, it is important to know them and keep observing if any side effects immerge and medical advice must be taken.

Side Effects of Intravenous Immune Globulins

About 5% of all patients, who are treated with Intravenous Immune Globulins, have reported to have encountered certain side effects or adverse effects. Knowing about them is important as it will let you know when to see a doctor.

  • General Side Effects: The generic side effects of intravenous immune globulins include –
    • Sudden gain of weight
    • Less than usual urination or no urination at all
    • Colour of urine changing to pink or red
    • Black or tarry stools
    • Increased thirst
    • Drowsiness
    • Loss of appetite
    • Feeling short of breath
    • Chest tightness
    • Rapid breathing
    • Wheezing
    • Confusion
    • Unusual bleeding from mouth, nose, rectum or vagina
    • Mood changes
    • Feeling as if you might pass out
    • Red or purple spots under skin
    • Nausea and vomiting
    • Sudden weakness
    • Numbness
    • Swelling
    • Sudden cough
    • Coughing up blood
    • Chest pain
    • Warmth or swelling in one or both legs
    • Fever with headache
    • Sudden severe headache
    • Stiffness in neck
    • Easy bruising
    • Convulsions
    • Increased sensitivity to light.
  • Specific Side Effects of Intravenous Immune Globulins: The more specific and serious side effects of intravenous immune globulins which requires immediate medical attention are as follows –
    • Anaphylactoid Reactions as a Side Effect of Intravenous Immune Globulins: Those, who have IgA deficiency, are found to suffer from serious anaphylactoid reactions. In that case, the IgA-depleted immune globulin needs to be used.
    • Other Side Effects of Intravenous Immune Globulins: Often eczematous reactions and dyshidrotic eczema or Pompholyx reactions are associated with Intravenous Immune Globulins therapy.
    • Intravenous Immune Globulins Causing Acute Renal Failure: With the sucrose-stabilized formulation of the Intravenous Immune Globulins, acute renal failures have been reported in a number of cases. However, the D-sorbitol–stabilized formulation of the Intravenous Immune Globulins has no association with renal failures.
    • Thrombosis: Yet another side effect or adverse effect of Intravenous Immune Globulins is thrombosis that can cause –
      • Transient serum sickness
      • Disseminated intravascular coagulation
      • Transient neutropenia.

    But of course, these are rare case of IVIG.

  • Infections: Hepatitis C, human parvovirus B19 infection etc. are life-threatening infections that have been reported to be transmitted with Intravenous Immune Globulins.
  • Skin Problems: Intravenous Immune Globulin therapy can also cause side effects of skin diseases like alopecia and eczematous dermatitis.
  • Cardiac Problems: According to a study report, heart problems like transient ischemic attacks, strokes, deep venous thrombosis, inferior wall myocardial infarction and retinal artery infarct occur in many patients after Intravenous Immune Globulin therapy. Those, who have a previous history of stroke and cardio-vascular diseases, hypertension, atrial fibrillation and hypercholesterolemia, and are above 60 years of age, are at an increased risk of acquiring these side effects while undergoing the Intravenous Immune Globulin therapy.
  • Other Diseases as a Side Effect of Intravenous Immune Globulins: Aseptic meningitis is a condition that is a consequence of the Intravenous Immune Globulin therapy. The white blood cells, in this condition, increases in the cerebral-spinal fluid.

Conclusion

The tolerance for Intravenous Immune Globulin therapy develops gradually and it cannot be pre-determined how a patient will react to a single dose or a specific regimen. However, of course, factors like pre-medication, rate of infusion and the product that is used, will determine the tolerance level. Many a times, switching between the different brands is also a persistent cause of the side effects. Hence, before taking in the dose, the protocol and the dosage instructions must properly be noted.

It must also be mentioned that the common side effects of Intravenous Immune Globulins gradually subside with time. However, if they trouble a lot, seeing a doctor is a must. Moreover, the dosage of the Intravenous Immune Globulins is so small that the side effects will never be systemic, but occur slowly. Changes in the dosage often reduce the side effects.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: June 14, 2017

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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