Immunoglobulins

Intravenous immunoglobulins, commonly referred to as IVIg, are being increasingly used for a variety of medical conditions. There are six preparations currently available in the United States. Several incidences of transmission of the hepatitis C virus have been documented with use of these products. The current indications for use are as follows:

1. Primary and secondary immunodeficiency, such as in patients with congenital immunodeficiency or chronic lymphocytic leukemia, bone marrow transplant patients, pediatric patients infected with the human immunodeficiency virus (HIV-1), and for the prevention of sepsis in premature infants and of infection in patients in intensive care settings.

2. Patients with immune or inflammatory disorders such as immune thrombocytopenic purpura or Kawasaki syndrome.

Two notable and interesting complications that may occur with the infusion of immunoglobulins are (1) anaphylaxis, which can occur in patients with IgA deficiency; these patients need to be given the IgA-depleted product; and (2) development of transient positive serologies in some patients due to the passive transfer of antibodies against hepatitis C and cytomegalovirus (CMV)

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