Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Transfus Med Rev. 2013 Jul;27(3):171-8. doi: 10.1016/j.tmrv.2013.05.004. Epub 2013 Jul 6.
Human immunoglobulin (IG) is used for IgG replacement therapy in primary and secondary immunodeficiency, for prevention and treatment of certain infections, and as an immunomodulatory agent for autoimmune and inflammatory disorders. IG has a wide spectrum of antibodies to microbial and human antigens. Several high-titered IGs are also available enriched in antibodies to specific viruses or bacterial toxins. IG can be given intravenously (IGIV), intramuscularly (IGIM) or by subcutaneous infusions (SCIG). Local adverse reactions such as persistent pain, bruising, swelling and erythema are rare with IGIV infusions but common (75%) with SCIG infusions. By contrast, adverse systemic reactions are rare with SCIG infusions but common with IGIV infusions, occurring as often as 20% to 50% of patients and 5% to 15% of all IGIV infusions. Systemic adverse reactions can be immediate (60% of reactions) occurring within 6 hours of an infusion, delayed (40% of reactions) occurring 6 hours-1 week after an infusion, and late (less than 1% of reactions), occurring weeks and months after an infusion. Immediate systemic reactions such as head and body aches, chills and fever are usually mild and readily treatable. Immediate anaphylactic and anaphylactoid reactions are uncommon. The most common delayed systemic reaction is persistent headache. Less common but more serious delayed reactions include aseptic meningitis, renal failure, thromboembolism, and hemolytic reactions. Late reactions are uncommon but often severe, and include lung disease, enteritis, dermatologic disorders and infectious diseases. The types, incidence, causes, prevention, and management of these reactions are discussed.
人免疫球蛋白（IG）用于原发性和继发性免疫缺陷的 IgG 替代治疗，用于预防和治疗某些感染，并作为自身免疫和炎症性疾病的免疫调节剂。IG 具有针对微生物和人类抗原的广泛抗体谱。一些高滴度的 IG 也可用于富集针对特定病毒或细菌毒素的抗体。IG 可通过静脉内（IGIV）、肌肉内（IGIM）或皮下输注（SCIG）给予。IGIV 输注时很少出现局部不良反应，如持续疼痛、瘀伤、肿胀和红斑，但 SCIG 输注时常见（75%）。相比之下，SCIG 输注时很少出现全身不良反应，但 IGIV 输注时常见，发生率高达 20%至 50%的患者和 5%至 15%的所有 IGIV 输注。全身不良反应可立即发生（60%的反应），在输注后 6 小时内发生，也可延迟发生（40%的反应），在输注后 6 小时至 1 周发生，还可迟发发生（<1%的反应），在输注后数周和数月发生。立即发生的全身反应，如头痛、身体疼痛、寒战和发热，通常较轻且易于治疗。立即过敏反应和类过敏反应不常见。最常见的延迟全身反应是持续性头痛。不太常见但更严重的延迟反应包括无菌性脑膜炎、肾衰竭、血栓栓塞和溶血性反应。迟发反应不常见但常很严重，包括肺病、肠炎、皮肤病和传染病。讨论了这些反应的类型、发生率、原因、预防和管理。
