PMID- 16391392
OWN - NLM
STAT- MEDLINE
DCOM- 20060329
LR  - 20181113
IS  - 1080-0549 (Print)
IS  - 1080-0549 (Linking)
VI  - 29
IP  - 3
DP  - 2005 Dec
TI  - Intravenous immunoglobulin: adverse effects and safe administration.
PG  - 173-84
AB  - Intravenous immunoglobulin (IVIg) is administered for various indications and 
      generally considered a safe therapy. Most of the adverse effects (AEs) associated 
      with IVIg administration are mild and transient. The immediate AEs include 
      headache, flushing, malaise, chest tightness, fever, chills, myalgia, fatigue, 
      dyspnea, back pain, nausea, vomiting, diarrhea, blood pressure changes, 
      tachycardia, and anaphylactic reactions, especially in IgA-deficient patients. 
      Late AEs are rare and include acute renal failure, thromboembolic events, aseptic 
      meningitis, neutropenia, and autoimmune hemolytic anemia, skin reactions, and 
      rare events of arthritis. Pseudohyponatremia following IVIg is important to be 
      recognized. Renal failure, usually oliguric and transient, occurs mostly on using 
      sucrose-containing products owing to osmotic injury. Among high-risk patients who 
      have a previous renal disease, dehydration, diabetes mellitus, advanced age, 
      hypertension, hyperviscosity, or are treated by other nephrotoxic medications, 
      administration of a non-sucrose-containing IVIg product after accomplishing 
      hydration, in a low concentration and a slow infusion rate while supervising 
      urine output and kidney function, is recommended. Thromboembolic complications 
      occur because of hyperviscosity especially in patients having risk factors 
      including advanced age, previous thromboembolic diseases, being bedridden, 
      diabetes mellitus, hypertension, dyslipidemia, or those receiving high-dose IVIg 
      in a rapid infusion rate. Immediate AEs can be treated by the slowing or 
      temporary discontinuation of the infusion and symptomatic therapy with 
      analgesics, nonsteroidal anti-inflammatory drugs, antihistamines, and 
      glucocorticoids in more severe reactions. Slow infusion rate of low concentration 
      of IVIg products and hydration, especially in high-risk patients, may prevent 
      renal failure, thromboembolic events, and aseptic meningitis.
FAU - Orbach, Hedi
AU  - Orbach H
AD  - Department of Medicine B, Wolfson Medical Center, Holon, Israel.
FAU - Katz, Uriel
AU  - Katz U
FAU - Sherer, Yaniv
AU  - Sherer Y
FAU - Shoenfeld, Yehuda
AU  - Shoenfeld Y
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Clin Rev Allergy Immunol
JT  - Clinical reviews in allergy & immunology
JID - 9504368
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
MH  - Acute Kidney Injury/etiology
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - Immunoglobulins, Intravenous/*administration & dosage/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Thromboembolism/etiology
RF  - 59
EDAT- 2006/01/05 09:00
MHDA- 2006/03/30 09:00
CRDT- 2006/01/05 09:00
PHST- 2006/01/05 09:00 [pubmed]
PHST- 2006/03/30 09:00 [medline]
PHST- 2006/01/05 09:00 [entrez]
AID - CRIAI:29:3:173 [pii]
AID - 10.1385/CRIAI:29:3:173 [doi]
PST - ppublish
SO  - Clin Rev Allergy Immunol. 2005 Dec;29(3):173-84. doi: 10.1385/CRIAI:29:3:173.