Clinical usage of intravenous immunoglobulins in Auckland

To review the indications for prescription of intravenous immunoglobulin (IVIg), in Auckland and the associated adverse effects.

All patients who received IVIg infusions in four major hospitals in Auckland in 1996 were identified from blood bank records. Clinical details were recorded from case notes.

One hundred and thirty-five cases were identified and 131 records were available for review. Hypogammaglobulinaemia (n = 38) and thrombocytopenia (n = 38) were the two most common indications for 44% of Primary hypogammaglobulinaemia accounted for IVIg. the IVIg prescribed. IVIg was only used in one patient with hypogammaglobulinaemia secondary to chronic lymphocytic leukaemia and in one case of graft-versus-host disease. Adverse reactions were noted in 13 cases (10%). Headache (n = 4) and fever (n = 4) were the most commonly recorded side-effects. One patient developed acute renal failure after IVIg infusion. Written consent was documented in 7 patients (5%).

The indications for IVIg prescription were generally consistent with the recommendations of the Australasian Society of Blood Transfusion. Use of IVIg in haematological conditions other than immune thrombocytopaenic purpura was infrequent. Most of the IVIg infusions were administered uneventfully but some minor side effects were recorded and one significant clinical event may have been causally related to IVIg infusion.