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Anaphylaxis to IVIG
Sharon Julie Williams1, Sudhir Gupta2
1Division of Basic and Clinical Immunology, University of California Irvine, Irvine, CA, USA. swillia3@uci.edu.
Archivum Immunologiae Et Therapiae Experimentalis
|July 15, 2016
Summary
Anaphylaxis can occur in patients with common variable immunodeficiency (CVID) receiving intravenous immunoglobulin (IVIG). This review examines 23 case reports, analyzing factors contributing to these reactions and potential desensitization strategies.
Area of Science:
- Immunology
- Allergy and Clinical Immunology
Background:
- Anaphylactic reactions are a known complication in some IgA-deficient patients receiving blood products.
- Patients with common variable immunodeficiency (CVID) receiving intravenous immunoglobulin (IVIG) have also experienced anaphylaxis, despite impaired vaccine responses but retained autoantibody production.
- This highlights a specific risk associated with IVIG therapy in antibody immunodeficient individuals.
Purpose of the Study:
- To review IgA antibodies, IgG- and IgE-mediated reactions in CVID and hypogammaglobulinemia patients.
- To analyze anaphylaxis occurrences in antibody immunodeficient patients receiving IVIG.
- To explore proposed mechanisms for desensitization and prevention of anaphylactic reactions during IVIG therapy.
Main Methods:
- Systematic review and assessment of 23 documented case reports of anaphylactic reactions in immunodeficient patients receiving IVIG since 1962.
- Comparison of patient immunoglobulin levels, IgG and IgE anti-IgA antibodies, IVIG concentration, IgA content in IVIG, antibody detection methods, treatment duration, and subsequent tolerated treatments.
Main Results:
- The study synthesizes data from 23 case reports detailing anaphylactic reactions in immunodeficient patients undergoing IVIG therapy.
- Analysis includes a comparative assessment of various clinical and laboratory parameters associated with these reactions.
Conclusions:
- Understanding the mechanisms behind anaphylaxis in IVIG-treated patients is crucial for developing effective prevention and desensitization strategies.
- Further research into IgG and IgE anti-IgA antibodies may elucidate the specific triggers for anaphylaxis in this patient population.
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