Adverse events associated with intravenous immunoglobulin therapy

Hamrock, David J.

doi:10.1016/j.intimp.2005.11.015

Cited by 147 publications

(141 citation statements)

References 84 publications

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“…These include low-grade fever, headache, nausea, malaise, arthralgia, chest pain and tightness, rashes, hypotension, and myalgia. 11,14 Maximum possible infusion rates are listed in Table 1, and range from 0.067 to 0.1 ml/kg/min. Diagnosis, treatment, and monitoring of patients experiencing these AEs increase the total cost of treatment.…”

Section: Infusion Ratementioning

confidence: 99%

“…If patients experience any of the side effects noted above, the providers are advised to slow the rate of infusion and/or use preinfusion medications such as diphenhydramine, acetaminophen, nonsteroidal antiinflammatory drugs, or corticosteroids before initiating the IGIV infusion. 11 Change of product may also affect the tolerability of IGIV for individual patients. Switching to a different IGIV product is recommended when the patient exhibits repeated adverse reactions to an IGIV product despite infusion rate adjustments and the use of preinfusion medications.…”

Section: Infusion Ratementioning

confidence: 99%

“…[2][3][4][5][6][7][8] The variability among products can influence tolerability, particularly in patients with preexisting risk factors and in patients receiving high doses of IGIV. [9][10][11][12][13] Estimates of the rate of adverse events (AEs) vary considerably (~2% to 25%), depending on the patient population.…”

mentioning

confidence: 99%

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Expert Opinion Regarding Clinical and Other Outcome Considerations in the Formulary Review of Immune Globulin

Sorensen

2007

JMCP

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Section: Infusion Ratementioning

confidence: 99%

Section: Infusion Ratementioning

confidence: 99%

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Expert Opinion Regarding Clinical and Other Outcome Considerations in the Formulary Review of Immune Globulin

Sorensen

2007

JMCP

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“…Drug-induced meningitis as a diagnosis of exclusion was reported with other therapeutic antibodies too, most frequently with the application of intravenous immunoglobulins (IVIGs) [6,7]. Slowing the infusion rate, reducing the dose and premedication with steroids was proposed [5] in analogy to recommendations for the application of IVIGs [6,7].…”

Section: Introductionmentioning

confidence: 99%

“…Slowing the infusion rate, reducing the dose and premedication with steroids was proposed [5] in analogy to recommendations for the application of IVIGs [6,7]. This approach was associated with lack of recurrence only in two of three cases.…”

Section: Introductionmentioning

confidence: 99%

Cetuximab induced aseptic meningitis

Ulrich

Weiler

Weller

et al. 2015

Journal of Clinical Neuroscience

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We report a 67-year-old man with recurrent advanced oropharyngeal squamous cell carcinoma who developed aseptic meningitis, with first symptoms arising approximately 9hours after the first administration of cetuximab, and review the literature to identify key signs and symptoms of this condition. Cetuximab is a monoclonal antibody targeting the epidermal growth factor receptor which has been rarely associated with aseptic meningitis. Besides the case description, a MEDLINE search was performed. In five patients identified in the literature and our patient, the leading signs and symptoms included headache, neck stiffness and high fever developing within a few hours of the first cetuximab administration. Cerebrospinal fluid (CSF) analysis revealed severe pleocytosis (range: 528-2300/ l) with dominance of neutrophils ( 87%). Clinical recovery within 1-2weeks was accompanied by normalization of CSF cell count within 4-7days. Re-challenge with cetuximab at a reduced dose caused recurrent aseptic meningitis in one of three patients. In summary, aseptic meningitis is a rare complication after first cetuximab exposure that the clinician should be aware of. CSF analysis is the key to diagnosis and recovery is usually complete within days to weeks after withdrawal of the drug. Re-challenge may be considered but bears the risk of recurrence.

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