THE USE OF HUMAN GAMMA-GLOBULIN IN THE TR EATMENT OF COMMON VARIABLE IMMUNODEFICIENCY

BACKGROUND: The Indication for treatment with human gammaglobulin In p atients with primary hypogammaglobulinemia is well established. Noneth eless, there are no uniform criteria with regard to dosis, periodicity and route of administration. METHODS: Twenty seven patients with comm on variable Immunodeficiency (CVI) who received i.m. or i.v. treatment with gammaglobulin were studied, evaluating the secondary effects, st able levels of IgG achieved, control of symptomatology, clinical evolu tion and the need for adjuvant therapies. RESULTS: Intravenous adminis tration was more effective than intramuscular administration to achiev e higher total IgG serum levels (5.2 +/- 1.2 vs 3.5 +/- 1.6 g/l; p = 0 .07) in a shorter period of time (2.1 +/- 1.6 months vs 6.3 +/- 2.8 mo nths; p < 0.01) and with new few secondary effects. The dosis and peri odicity of the treatment was Individualized in each patient on the bas is of the needs of consumption and the speed of metabolism of the gamm aglobulin, with patients with chronic bronchial supuration and diarrhe a being those requiring the greatest doses (p < 0.0001) and a short in terdosis time Interval (19.2 +/- 3.1 vs 23.6 +/- 3.6 days; p = 0.01). Treatment with human gammaglobulin allowed the control of recurrent ba cterial Infection; however, adjuvant treatment with respiratory physic al measures and antibiotics were required in patients with chronic bro nchial suppuration to avoid progressive alteration of respiratory func tion. CONCLUSIONS: The administration of human gammaglobulin at adequa te doses and frequency is effective to control infection, avoid the de velopment of chronic bronchial disease, alteration of pulmonary functi on and the appearance of other complications. Intravenous route Is saf er and produces fewer secondary effects than Intramuscular administrat ion with the doses and period of the treatment requiring Individualiza tion for each patient