Adverse reaction following intravenous immunoglobulin in primary immunodeficiency patients

Intravenous immunoglobulin is used for primary immunodeficiency disorders. There have been some reports that intravenous immunoglobulin causes side effects. The aim of this study was to investigate intravenous immunoglobulin side effects in immunodeficiency patients. The study utilized the data of 29 primary immunodeficiency patients that were referred to allergy and immunology department in Medical Children Center in Tehran. 29 patients having completed record data files in the hospital, were the subjects of this study. Of 29 immune deficiency patients [aged 15 months to 55 years], they were 19 Males [65/51%] and 10 [34/48%] Females. Prevalence of disorders include common variable immunodeficiency 16 [55/17%], Bruton disease 8 [27/58%], hyper IgM 4 [13/79%] and severe combined immunodeficiency 1 [3/44%]. Based on the recorded data, the duration of infusion has been 5 months to 15 years. 15 patients had reported side effects [51/72%]. 34 infusions from the total of 1,626 infusions accompanied with side effects [2/09%]. Most side effects were occurred during 30 minutes onset of infusion and most were caused by rapid infusion. Most side effects were mild reactions [fever, chills and ...]. Intravenous immunoglobulin is a rather safe drug with mild side effects. With an appropriate technique and proper infusion, these side effects can be reduced

Assessment of IVIG treatment in children and its complications [Babol; 1999-2004]

IVIG is used in patients incapable of producing antibodies and in autoimmune disorders. IVIG infusion rarely causes undesirable reactions due to the speed of infusion. So, this study was performed to determine the indications and complications of IVIG infusion. This descriptive study was performed on 265 patients, hospitalized in Amirkola pediatric hospital, needing IVIG infusions, from October 1999 to June 2004. Data was analyzed by SPSS. T-test, chi square and fisher exact test were used to compare drug complications based on age and speed of infusion in two genders. In this research, 265 patients with 871 infusions were studied. One hundred and thirty one patients [49.4%] were male and 134 [50.6%] were female. Two patients [0.7%] had autoimmune hemolytic anemia, one patient [0.3%] had ataxia telangectasia, 9 patients [3.4%] had refractory seizure, 2 patients [0.7%] had guillain-barre syndrome, 83 patients [31.3%] had immune thrombocytopenic purpura, 46 patients [17.3%] had kawasaki, 51 patients [19.2%] had immunodeficiency and 72 patients [27.1%] were premature neonates. Among the studied patients, 17 infusions [1.95%] had complications, which were mild in 14 patients [82.5%], moderate in 2 patients [11.7%] and severe in 1 patient [5.8%]. Complication was the same in both genders, and it had a significant difference with the speed of drug infusion [P<0.05]. The most common cause of IVIG infusion is immune thrombocytopenic purpura. Complications are usually mild and had relationship with the speed of drug infusion

Biliary pseudolithiasis during ceftriaxone therapy in children

Ceftriaxone is almost widely used in the treatment of pediatric infection and this is accompanied by some complications. The aim of this study was to determine the incidence of abnormal ultrasonography findings of gallbladder [pseudolithiasis or sludge] during ceftriaxon therapy and its relation to fasting, sex and G6PD deficiency. This quasi-experimental survey was done in Amirkola Children's Hospital, Babol, Iran. First ultrasonography was done before initiation of ceftriaxone therapy and it was repeated 24-48 hours after therapy and in the 5th, 7th, 10th and 14th day after the treatment. If abnormal finding was seen, ultrasonography was done weekly in the first two weeks until the side effect disappeared. Data was collected and analyzed by SPSS software. Of all 108 patients, who were between 3 months to 10 years old, 20 cases had abnormal findings in gallbladder [2 sludges and 18 pseudolithiases]. Length of fasting before ceftriaxone therapy had a positive relation with possibility of stone formation [p<0.005], but age, sex, duration of therapy and G6PD deficiency were not related [p>0.05]. In four cases pseudolithiasis was formed after only 1-2 doses of ceftriaxone. Shortest and longest periods of resolution of complications were 1 and 17 days respectively after formation. Incidence of pseudolithiasis or sludge formation during ceftriaxone therapy was 18.5% and fasting had a great effect on these complications