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Intravenous Immunoglobulins as Therapeutic Agents
- E. RICHARD STIEHM, M.D.;
- ELLYN ASHIDA, M.D.;
- KWANG SIK KIM, M.D.;
- DREW J. WINSTON, M.D.;
- ALBERT HAAS, M.D.; and
- ROBERT P. GALE, M.D., Ph.D.
Abstract
Intravenous immunoglobulins are stable monomeric pooled human IgG preparations for therapeutic use. Three intravenous immunoglobulins licensed in the United States are generally therapeutically equivalent. Intravenous immunoglobulin is the preferred agent for replacement therapy for most patients with primary or secondary antibody immunodeficiency because of the rapidity and ease of giving large quantities of IgG, even by self-administration. Disadvantages of intravenous immunoglobulins include frequent (approximately 10%) but usually not serious side effects, the need for venous access (often difficult in infants and young children), and high cost. Intravenous immunoglobulins are also beneficial in the prevention of certain viral infections, such as cytomegalovirus pneumonia and varicella; they may also have a synergistic effect with antibiotics in certain bacterial diseases. Intravenous immunoglobulin has also been used successfully in the management of idiopathic thrombocytopenia purpura, Kawasaki disease, and certain autoimmune diseases. Intravenous immunoglobulin may also be of use in certain high-risk and premature newborns.
- acquired immunodeficiency syndrome
- agammaglobulinemia
- autoimmune diseases
- bacterial infections
- cytomegalic inclusion disease
- IgG
- immunologic deficiency syndromes
- immunization, passive
- immunoglobulins
- infant, newborn
- injections, intramuscular
- leukemia, lymphocytic
- mucocutaneous lymph node syndrome
- purpura, thrombocytopenic
- self administration
- virus diseases
- Gamimune-N
- Gammagard
- immune globulins, intravenous
- Sandoglobulin
- acquired immunodeficiency syndrome
- agammaglobulinemia
- autoimmune diseases
- bacterial infections
- cytomegalic inclusion disease
- IgG
- immunologic deficiency syndromes
- immunization, passive
- immunoglobulins
- infant, newborn
- injections, intramuscular
- leukemia, lymphocytic
- mucocutaneous lymph node syndrome
- purpura, thrombocytopenic
- self administration
- virus diseases
- Gamimune-N
- Gammagard
- immune globulins, intravenous
- Sandoglobulin
Article and Author Information
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▸An edited summary of an Interdepartmental Conference arranged by the Department of Medicine of the UCLA School of Medicine, Los Angeles, California. William M. Pardridge, M.D., Professor of Medicine, is Director of Conferences.
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▸Authors who wish to cite a section of the conference and specifically indicate its author can use this example for the form of reference:
HAAS A. Use of intravenous immunoglobulin in immunoregulatory disorders, pp 374-7. In: STIEHM ER, moderator. Intravenous immunoglobulins as therapeutic agents. Ann Intern Med. 1987;107:367-82.
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Grant support: in part by grants HD-09800, AI-07008, and AI-15332 to Dr. Stiehm; the University AIDS Task Force to Dr. Ashida; AI-19454/22420 and grant no. 1-976 from the March of Dimes Birth Defects Foundation to Dr. Kim; and CA-23175 and RR-00865 to Dr. Winston.
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▸Requests for reprints should be addressed to E. Richard Stiehm, M.D.; Department of Pediatrics, Division of Allergy and Immunology, UCLA School of Medicine; Los Angeles, CA 90024.
- © 1987 American College of Physicians
