Administering intravenous immunoglobulin during infection is associated with infusion reactions in selected patients

Khan, Sujoy; Abuzakouk, Mohamed; Doré, P.; Sewell, William A.

doi:10.1007/s11845-010-0654-4

Cited by 2 publications

(1 citation statement)

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“…IVIg are often dispensed as a 5% solution; the effects of inappropriate volume loading in critically ill patients could be detrimental. In addition, subclinical sepsis can be associated with IVIg infusion reactions in patients with antibody deficiency [160]. …”

Section: Clinical Trials In Sepsis Syndromesmentioning

confidence: 99%

Bench-to-bedside review: Immunoglobulin therapy for sepsis - biological plausibility from a critical care perspective

et al. 2011

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Sepsis represents a dysregulated host response to infection, the extent of which determines the severity of organ dysfunction and subsequent outcome. All trialled immunomodulatory strategies to date have resulted in either outright failure or inconsistent degrees of success. Intravenous immunoglobulin (IVIg) therapy falls into the latter category with opinion still divided as to its utility. This article provides a narrative review of the biological rationale for using IVIg in sepsis. A literature search was conducted using the PubMed database (1966 to February 2011). The strategy included the following text terms and combinations of these: IVIg, intravenous immune globulin, intravenous immunoglobulin, immunoglobulin, immunoglobulin therapy, pentaglobin, sepsis, inflammation, immune modulation, apoptosis. Preclinical and extrapolated clinical data of IVIg therapy in sepsis suggests improved bacterial clearance, inhibitory effects upon upstream mediators of the host response (for example, the nuclear factor kappa B (NF-κB) transcription factor), scavenging of downstream inflammatory mediators (for example, cytokines), direct anti-inflammatory effects mediated via Fcγ receptors, and a potential ability to attenuate lymphocyte apoptosis and thus sepsis-related immunosuppression. Characterizing the trajectory of change in immunoglobulin levels during sepsis, understanding mechanisms contributing to these changes, and undertaking IVIg dose-finding studies should be performed prior to further large-scale interventional trials to enhance the likelihood of a successful outcome.

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Section: Clinical Trials In Sepsis Syndromesmentioning

confidence: 99%

Bench-to-bedside review: Immunoglobulin therapy for sepsis - biological plausibility from a critical care perspective

et al. 2011

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A review on guidelines for management and treatment of common variable immunodeficiency

Abolhassani

Sagvand

Shokuhfar

et al. 2013

Expert Review of Clinical Immunology

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Administering intravenous immunoglobulin during infection is associated with infusion reactions in selected patients

Abstract: Some patients with IVIG reactions had elevated CRP levels suggesting that concurrent infection may have caused the reaction. Pre-emptive antibiotic therapy and delaying infusion could prevent unnecessary morbidity.

Cited by 2 publications

References 10 publications

Bench-to-bedside review: Immunoglobulin therapy for sepsis - biological plausibility from a critical care perspective

Bench-to-bedside review: Immunoglobulin therapy for sepsis - biological plausibility from a critical care perspective

A review on guidelines for management and treatment of common variable immunodeficiency

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