HOME THERAPY WITH SUBCUTANEOUS IMMUNOGLOBULIN INFUSIONS IN CHILDREN WITH CONGENITAL IMMUNODEFICIENCIES

Objectives. Patients with congenital,humoral immunodeficiencies are us ually treated with intravenous immunoglobulin infusions. Subcutaneous infusions have emerged as an alternative treatment modality also in ch ildren. Our institution has run a subcutaneous infusion home therapy p rogram for 6 years, and the purpose of this report is to describe our experience with this regimen. Methods. The subcutaneous therapy of eig ht patients with immunodeficiency (three with agammaglobulinemia, one with common variable immunodeficiency, one with severe combined immuno deficiency and bone marrow transplantation, and three with hyper-immun oglobulin M syndrome) was evaluated by chart review and a questionnair e answered by all the families. The infusions were given for at least 3 hours each week by a small syringe driver at home after the family h ad attended an intensive educational course at the hospital. Results. The children were given a total of approximately 1100 infusions. They started at the age of 2 to 8 (mean, 4.5) years and received these infu sions for 1.5 to 6 (mean, 3) years. By administering immunoglobulin do ses from 58 to 149 (mean, 97) mg/kg per week, trough serum immunoglobu lin G values from 5.2 to 9.6 (mean, 7) g/L were obtained. No serious i nfections occurred. Shortlasting, local side effects such as swelling and redness were frequently reported, but pain or systemic adverse rea ctions during or after the infusions were never encountered. Conclusio ns. Home therapy with subcutaneous immunoglobulin infusions in childre n with congenital immunodeficiencies is a feasible and safe treatment alternative.