Kaba S, Keskindemirci G, Aydogmus C, Siraneci R, Erol Cipe F
Yuzuncu Yil University, School of Medicine, Deparment of Pediatrics, Van, Turkey.
Kanuni Sultan Suleyman Research and Training Hospital, Department of Pediatric Allergy-Immunology, Istanbul, Turkey.
Eur Ann Allergy Clin Immunol. 2017 Jan;49(1):11-14.
Intravenous immunoglobulin (IVIG) is commonly used in primary and secondary immunodeficiency diseases as well as autoimmune conditions as immunomodulatator treatment. Immediate adverse events which are generally mild and occur during infusion are seen in 6 hours. Reported immediate adverse events are in a wide range from 1%-40% in pediatric patients. 115 patients who received IVIG (except newborns) were included into this crosssectional study. IVIG was given to patients for primary immunodeficiencies (n=8), ITP (n=65), Kawasaki disease (n=11), secondary immunosupression (n=28), and passive immunization (n=3). 5%, 10% IVIG preparations and pentaglobin were used. Headache, fever, chills, nausea, rash, arthralgia, myalgia and back pain were accepted as mild immediate events. There were 62 (54%) boys and 53 (46%) girls aged 1 month-18 years. Mean age of the group was 7.4±4.6 years. Immediate adverse events due to IVIG infusions were seen in 29 (25.2%) of all patients. Gender and types of the disease were not different in significance regarding the presence of adverse events. The rate of adverse events did not change with receiving pre-medication. The most common reaction was fever/chills. Immediate reactions were seen in first 6 hours in 7 patients and during infusion in the remaining. They were treated with slowing of the infusion rate and infusion was stopped in 3 patients because of moderate events. Because of the increasingly use of IVIG therapy, it is important to know the side effects. High doses, high infusion rates, accompanying infection may worsen the adverse effects especially in primary immunodeficiency diseases.
静脉注射免疫球蛋白（IVIG）作为免疫调节治疗药物，常用于原发性和继发性免疫缺陷疾病以及自身免疫性疾病。一般在输液过程中出现的即刻不良事件通常较为轻微，多在6小时内出现。据报道，儿科患者中即刻不良事件的发生率在1%至40%之间。本横断面研究纳入了115例接受IVIG治疗的患者（新生儿除外）。给予患者IVIG用于原发性免疫缺陷（n = 8）、免疫性血小板减少症（ITP，n = 65）、川崎病（n = 11）、继发性免疫抑制（n = 28）和被动免疫（n = 3）。使用了5%、10%的IVIG制剂和五聚体球蛋白。头痛、发热、寒战、恶心、皮疹、关节痛、肌痛和背痛被视为轻微即刻事件。共有62名（54%）男孩和53名（46%）女孩，年龄在1个月至18岁之间。该组的平均年龄为7.4±4.6岁。所有患者中有29例（25.2%）出现了IVIG输注引起的即刻不良事件。在不良事件的发生方面，性别和疾病类型无显著差异。接受预处理并未改变不良事件的发生率。最常见的反应是发热/寒战。7例患者在最初6小时内出现即刻反应，其余患者在输液过程中出现。对反应的处理是减慢输液速度，3例患者因中度反应而停止输液。由于IVIG治疗的使用日益增加，了解其副作用很重要。高剂量、高输液速度以及合并感染可能会使副作用加重，尤其是在原发性免疫缺陷疾病中。
