Adverse effects of intravenous immunoglobulin therapy in 56 patients with autoimmune diseases

Objective: To test the adverse effects and viral safety of intravenous immu noglobulin (IVIg) use in autoimmune diseases. Methods: Fifty-six patients w ith various autoimmune diseases who were treated with one to six IVIg cours es were evaluated for the presence of adverse effects following IVIg therap y and were screened before a nd after the treatment for the presence of ser um human immunodeficiency virus antibodies, hepatitis C virus antibodies, a nd hepatitis B surface antigen. Results: Among the 56 patients, 20 (36%) ha d at least one adverse effect following at least one of the treatment cours es. These included headache, low-grade fever, chills, anemia, low-back pain , transient hypotension, nausea, intensified perspiration, and superficial and deep vein thromboses. Whereas the presence of adverse effect to IVIg wa s unrelated to either the clinical response to the treatment or to the natu re of the autoimmune disease, the occurrence of an adverse effect in the fi rst treatment course was significantly associated with a greater chance for an adverse effect in the subsequent courses. No transmission of any of the three viral agents examined could be detected. Conclusions: Although IVIg use in autoimmune diseases is associated with adverse effects in about one third of the patients, these effects are usually mild and transient. Patien ts who develop adverse effects during the first treatment course may be at increased risk of adverse effects during the subsequent IVIg courses. Copyr ight (C) 2001 S. Karger AG, Basel.