Managing patients with side effects and adverse events to immunoglobulin therapy

Abstract

Immunoglobulin therapy has not only served as a lifesaving approach for the prevention and treatment of infections in primary and secondary immunodeficiency diseases, but has also been used as an immunomodulatory agent for autoimmune and inflammatory disorders and to provide passive immunity for some infectious diseases. Most of the adverse effects associated with immunoglobulin therapy are mild, transient and self-limiting. However, serious side effects also occur. Therefore, to minimize the adverse events of immunoglobulin therapy, specialist review of patient clinical status and immunoglobulin products, in addition to selection of appropriate treatment strategy for the management of patients with associated side effects and adverse events, are crucial.

Keywords:

• Immunoglobulin therapy
• adverse events
• high dose immunomodulation
• routes of administration
• side effects

Key issues

• Immunoglobulin therapy has served as the main therapy in primary and secondary immunodeficiency and autoimmune and inflammatory disorders, and may be given by different routes, with several potential risks of adverse events.

• The antigenicity of the IgG, large molecular weight of the IgG aggregates, and complement activation or direct release of cytokines from mononuclear cells may be underlying mechanisms of adverse reactions in immunoglobulin therapy.

• The indications of immunoglobulin therapy indications should be carefully considered because of its costs, infusion discomfort and potential side effects.

• The manufacturing process and composition of immunoglobulin products is the main part of the training of caregivers dealing with patients as they may affect tolerability, adverse effects and clinical outcomes directly.

Financial & competing interests disclosure

The authors have no 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. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.