Makindo Medical Notes.com

IVIG contains IgG and so peripheral tissues that are defended mainly by IgA antibodies, such as the eyes, lungs, gut and urinary tract are not fully protected by the IVIG treatment

About: Always check the BNF link here

• IVIGs are sterile, purified immunoglobulin G (IgG) products
• Manufactured from a pool of over 1000 human plasma donors
• Contains more than 95% unmodified IgG, which has intact Fc-dependent effector functions
• Contains only trace amounts of immunoglobulin A (IgA) or immunoglobulin M (IgM).

Mode of action

• Saturates macrophage Fc receptors
• Modulation of complement activation
• Suppression of idiotypic antibodies
• Suppression of cytokines, chaemokines, and metalloproteinases
• Antibody may bind directly with the abnormal host antibody, stimulating its removal

Indications

• Chronic inflammatory demyelinating polyneuropathy
• Multifocal motor neuropathy with conduction block (MMN)
• Guillain-Barré Syndrome, Myasthenic crisis
• Autoimmune idiopathic thrombocytopenic purpura (ITP)
• Kawasaki disease, Dermatomyositis
• IVIG replacement prevents severe and lower respiratory tract infections, but not upper respiratory tract and non-respiratory infections in persons with common variable immune deficiency.
• Paediatric HIV disease

Dose (check BNF)

• IVIG Usually 2 mg/kg over 5 daily treatments as 0.4 g/kg/day administered for 5 consecutive days
• IVIG can be given in pregnancy
• It has a half-life of 3 weeks

Contraindications

• Not given to those with congenital IgA deficiency (check first)

Side effects

• Malaise, headache, chills, flushing, chest tightness, nausea
• Anaphylaxis, thrombotic events, stroke and MI (give slowly)
• Renal dysfunction
• Neutropenia and Haemolysis
• Aseptic meningitis
• Transmission of infection
• IVIgG can cause acute renal failure, especially in the elderly

References

• Summary Product Characteristics