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免疫球蛋白

IVIG 的长期副作用

Patient suffering from IVIG Long-term Side Effects

一般来说, 静脉注射免疫球蛋白(IVIG) 治疗 considered a standard, effective, and safe treatment. Although IVIG treatment is well-tolerated, adverse long-term side effects may occur

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IVIG is primarily used to treat a wide array of life-threatening disorders in which patients either have a dysfunctional immune system or are deficient in immune components such as antibodies. This therapy increases the life expectancy of patients suffering from immunodeficiency, autoimmune, and neurologic disorders and improves their quality of life.

If patients are suffering from primary and secondary immunodeficiency and require repetitive infusions of IVIG, this treatment can be lifelong. These patients often experience common side effects and sometimes may suffer from IVIG long-term side effects as well.

 

IVIG的副作用

Common Side Effects of IVIG

The side effects of IVIG may vary from patient to patient, depending on their health status. Approximately one-fourth of patients experience some common IVIG side effects over the course of their IVIG治疗

If you are receiving larger doses of IVIG, you may be more likely to experience mild and transient IVIG side effects. 

常见的副作用包括:

  • 头痛 or nausea
  • 冲洗
  • 不适
  • A chill or a fever
  • 胃痛
  • 胸部不适
  • 疲劳 
  • 昏睡

These minor IVIG symptoms can be dissipated by slowing the IV infusion rate. However, if you feel a persistent headache or any other symptoms mentioned above that do not settle down during or after the infusion, then consult your healthcare provider immediately. 

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Adverse and Long-term IVIG Side Effects

Unlike some disorders that respond to a single course of 静脉注射免疫球蛋白(IVIG)治疗, patients with chronic illnesses require repetitive IVIG infusions. For instance, in the case of primary immunodeficiency (PID) or neurologic disorders, a patient may require chronic IVIG treatment over a long period of time to maintain improvement. 

Limited data is available on the long-term side effects of IVIG. In very rare cases, it has been reported that chronic IVIG therapy can lead to severe side effects such as:

Patient receiving IVIG treatment1. Renal and Hematologic Side Effects

Research hints that patients on long-term IVIG therapy are more prone to renal failure (a condition in which a person’s kidneys stop working and are unable to filter blood and remove waste products from the body).

Supporting this hypothesis, a retrospective study conducted on 166 patients with neurologic disorder showed a decline in hematocrit (blood level) and a 20% or greater decline in GFR (glomerular filtrate rate). These patients received IVIG infusions with a dose range of 0.441 – 2.58 g/kg/month for 1 year.     

2. Thromboembolic Complications

Thromboembolic complications also fall into the category of long-term IVIG side effects. If a patient has a previous history of coronary artery disease or cardiovascular disease and is receiving IVIG infusion on a long-term basis, then the incidence of thromboembolic complications is higher in these patients. 

One study revealed that 11.3% of patients on regular IVIG treatment showed thromboembolic complications over a 24-month period. The researchers suggested that IVIG may have a contributing role in thromboembolic complications. 

3. Aseptic meningitis

Patients on IVIG treatment also experience acute aseptic meningitis (a condition in which the membrane called meninges covering the CNS becomes inflamed). Though the exact pathophysiology of aseptic meningitis is unclear, existing literature reveals that this is an IVIG-induced side effect. 

结论

Based on extensive research, IVIG treatment is considered a safe and effective treatment for managing various medical conditions. Long-term side effects may occur; however, they are rare, and data on IVIG’s long-term side effects are still scarce. 

如果您有兴趣了解有关 IVIG 不同方面的更多信息,请访问我们的 IVIG 患者资源中心.

参考:

  1. Levine, A. A., Levine, T. D., Clarke, K., & Saperstein, D. (2017). Renal and hematologic side effects of long‐term Intravenous immunoglobulin therapy in patients with neurologic disorders. 肌肉和神经56(6), 1173-1176.
  2. Kapoor, M., Spillane, J., Englezou, C., Sarri-Gonzalez, S., Bell, R., Rossor, A., … & Carr, A. (2020). Thromboembolic risk with IVIg: incidence and risk factors in patients with inflammatory neuropathy. 神经病学94(6), e635-e638.
  3. Rajabally, Y. A., & Kearney, D. A. (2011). Thromboembolic complications of intravenous immunoglobulin therapy in patients with neuropathy: a two-year study. Journal of the neurological sciences308(1-2), 124-127.
  4. White, D. A., & Leonard, M. C. (2007). Acute stroke with high-dose intravenous immune globulin. American journal of health-system pharmacy64(15), 1611-1614.
此信息不能替代医疗建议或治疗。在开始任何新的治疗之前,请咨询您的医生或医疗保健提供者,了解您的医疗状况。AmeriPharma® Specialty Care 对所提供的信息或由此做出的任何诊断或治疗不承担任何责任,也不对其内容的可靠性负责。AmeriPharma® Specialty Care 并非运营此处列出的所有网站/组织,也不对其内容的可用性或可靠性负责。这些列表并不暗示或构成 AmeriPharma® Specialty Care 的认可、赞助或推荐。本网页可能包含对品牌处方药的引用,这些处方药是与 AmeriPharma® Specialty Care 无关的制药商的商标或注册商标。
Portrait of Haresh J., a doctor sharing his expertise.
医学审核人 Dr. Haresh Jhangiani, MD, FACP, MBA

Dr. Haresh Jhangiani, MD, FACP, MBA, was born and raised in Bombay, India. He received his degree from the University of Bombay in 1978 with honors. He has been nominated several times for OC Physician of the Year. Dr. Jhangiani is a clinical assistant professor at USC and UC Irvine, and he is currently precepting students from UC Riverside. He has 34 years of experience, and the most rewarding part of his job is taking care of patients. In his free time, Dr. Jhangiani enjoys fine dining and attending the theater.

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