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Open Access Not All Intravenous Immunoglobulin Preparations are Equally Well Tolerated

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Intravenous immunoglobulin (IVIG) is used for many indications beyond the original substitution in primary antibody deficiency. Whereas many reports mention adverse reactions, no comparative data exist concerning the incidence of side-effects among the different brands of IVIG. We describe here our experience with the use of different IVIG formulations and their tolerability in a select cohort of 40 patients. The IVIG dose ranged from 0.4 to 3 g/kg/day and was given for 1–2742 days. Fourteen patients (35%) experienced mild to severe adverse reactions during or within 48 h of administration of standard IVIG preparation, which did not recur after switching to an alternative preparation. Adverse reactions included headache, fever, chills, nausea, emesis, hypotension and muscle cramps. One patient experienced a severe adverse reaction; he had a 3-day headache following IVIG infusion. Among the 16 patients who received alternative preparation initially, none experienced adverse reactions. In conclusion, this study shows that IVIG preparations are not all equally well tolerated in patients. The data suggest that, perhaps to a comparable extent to the preparation itself, the infusion rate has a major effect. If a reduction in the infusion rate does not minimize side-effects, one should consider switching the IVIG formulation.

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Keywords: ADVERSE DRUG REACTION; HYPOGAMMAGLOBULINAEMIA; INTRAVENOUS IMMUNOGLOBULIN; LUNG TRANSPLANTATION; PREVENTION; TOXIC EPIDERMAL NECROLYSIS

Document Type: Conference Report

Publication date: September 1, 2010

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  • Acta Dermato-Venereologica is a bi-monthly international peer-reviewed journal for clinical and experimental research in the field of dermatology and venereology.

    It was founded in 1920 by Johan Almqvist and edited during 1936-1969 by Sven Hellerström. Since 1970, the journal has been published for the Society for the Publication of Acta Dermato-Venereologica on a non-profit basis.

    Acta Dermato-Venereologica publishes high-quality manuscripts in English dealing with new observations on basic dermatological and venereological research, as well as clinical investigations. Each volume also features a number of review articles in special areas, as well as short Letters to the Editor to stimulate debate and to disseminate important clinical observations. Acta Dermato-Venereologica has rapid publication times and is amply illustrated with a large number of colour photographs to enhance understanding.

    Acta Dermato-Venereologica covers inter alia:

    • ~ Atopic dermatitis and contact allergy
    • ~ Facial dermatoses and adnexal disorders
    • ~ New treatments
    • ~ Psoriasis and genodermatoses
    • ~ Psychodermatology
    • ~ Sexually transmitted diseases
    • ~ Skin biology and inflammation
    • ~ Skin cancer and pigmentation
    • ~ Skin immunology and lymphoma
    • ~ Urticaria and itch

    Extensive papers, proceedings from congresses and symposia are printed as supplements to the journal. Announcements concerning pertinent dermatological meetings and books received are also published.
    Readership: Doctors and scientists interested in dermatology, skin biology and venereology.

    Acta Dermato-Venereologica has an impact factor of 3.007.

    Issues between 1998 up to 2005 can be found at http://www.medicaljournals.se/acta/content

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