Vo Ashley A, Cam Vinh, Toyoda Mieko, Puliyanda Dechu P, Lukovsky Marina, Bunnapradist Suphamai, Peng Alice, Yang Kai, Jordan Stanley C
Comprehensive Transplant Center, Cedars-Sinai Medical Center, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California 90048, USA.
Clin J Am Soc Nephrol. 2006 Jul;1(4):844-52. doi: 10.2215/CJN.01701105. Epub 2006 Apr 26.
Intravenous Ig (IVIg) products are used in various medical conditions. Differences in excipients account for most adverse events (AE). Reports of complications including acute myocardial infarction (AMI) and acute renal failure (ARF) have emerged. Herein is described one institution's experience with IVIg-related complications. This study is a retrospective analysis of infusion-related AE that are associated with various IVIg products. Infusion-related AE were monitored during and after the administration of three IVIg products: Gamimune-N 10% (n = 76), Polygam (n = 105), and Carimune (n = 98). AE segregated to specific IVIg products. No patients who received Gamimune-N experienced AMI or ARF. Five (4.7%) patients (P < 0.01) in the Polygam group experienced AMI. Eight (8.2%) patients (P < 0.0001) in the Carimune group developed ARF. IVIg was safe to give on hemodialysis. IVIg products differ in osmolality, pH, and sugar and sodium content; this results in specific AE. Polygam resulted in no ARF but an increase in AMI. Carimune products at 9% concentration resulted in an increase in ARF. Gamimune-N 10% and other IVIg products were frequently associated with headaches. Administration of IVIg to patients who are on hemodialysis seems to be safe and effective.
静脉注射免疫球蛋白(IVIg)产品用于多种医疗状况。辅料差异是大多数不良事件(AE)的原因。包括急性心肌梗死(AMI)和急性肾衰竭(ARF)在内的并发症报告已经出现。本文描述了一家机构在IVIg相关并发症方面的经验。本研究是对与各种IVIg产品相关的输液相关AE的回顾性分析。在三种IVIg产品给药期间及之后监测输液相关AE:10%的Gamimune-N(n = 76)、Polygam(n = 105)和Carimune(n = 98)。AE与特定的IVIg产品相关。接受Gamimune-N的患者中无人发生AMI或ARF。Polygam组有5名(4.7%)患者(P < 0.01)发生AMI。Carimune组有8名(8.2%)患者(P < 0.0001)发生ARF。在血液透析时给予IVIg是安全的。IVIg产品在渗透压、pH值以及糖和钠含量方面存在差异;这导致了特定的AE。Polygam未导致ARF,但AMI有所增加。9%浓度的Carimune产品导致ARF增加。10%的Gamimune-N和其他IVIg产品经常与头痛相关。对接受血液透析的患者给予IVIg似乎是安全有效的。