Intravenous human immunoglobulin infusion adverse effects in patients with immunodeficiency

Background : Immunoglobulin treatment has changed the natural history of humoral immunodeficiencies and is considered to be safe, but adverse effects have been observed in 30- 40% of patients in the literature. Our study aimed to evaluate the frequency and severity of adverse reactions during the infusion of intravenous immunoglobulin. Method : Retrospective observational study of intravenous immunoglobulin infusions for the treatment of immunodeficiencies from August 2013 to April 2018 in a tertiary reference center. Results : Out of 149 patients, 119 infusion reactions were observed in 47 patients, with a similar distribution between genders. These patients were using immunoglobulin for common variable immunodeficiency (87%), secondary immunodeficiency (6%), agammaglobulinemia (4%) and Good syndrome (2%). Comorbidities more commonly observed were gastric, respiratory and endocrinological. Patients who had the highest frequency of reactions were those who were more than 50 years old, whose incidence was 39%. The adverse reactions were mild (63%) and the most frequent symptoms were most of tremors / chills and low back pain. Serious reactions occurred in few cases (4%) and manifested as anaphylaxis, convulsion and hypo / hypertension. Conclusion : Although immunoglobulin replacement therapy is considered safe. The most of reactions are mild, we should be alert especially to older patients with potentially serious reactions. In addition, patients at high risk for reactions or patients with prior history of reaction should follow prophylactic measures to prevent new reactions, such as reduction in infusion rate, rise of premedication and exchange of the infusion route. (Table Presented).