Immunoglobulin-induced hemolysis, splenomegaly and inflammation in patients with antibody deficiencies

ABSTRACT

IgG replacement for primary antibody deficiencies is a safe treatment administered to prevent recurrent infections and reduce mortality. Recently, several reports described acute hemolytic episodes following IgG administration due to a passive transfer of blood group alloantibodies, including anti-A, anti-B, as well as anti-Rh antibodies. Here, we reviewed and discussed the consequences of passively transferred RBCs antibodies. The chronic passive transfer of alloantibodies might also cause a subclinical condition due to a compensated extravascular chronic hemolysis with poorly understood consequences. This phenomenon might possibly represent an unrecognized cause of splenomegaly and might contribute to inflammation in patients with primary antibody deficiencies.

KEYWORDS:

• Primary Antibody Defects
• Hemolysis
• Immunoglobulin replacement therapy
• Immunoglobulin-Induced Hemolysis
• Common Variable Immune Deficiency
• Splenomegaly
• Inflammation

Financial and competing interests disclosure

This paper has been supported by the Jeffrey Modell Foundation, Fondazione Lorillard Spencer Cenci and Progetto Ricerche Universitarie Sapienza, 2011, 2012. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.