Intravenous gamma-globulin infusions in patients with hypo-gamma-globulinemia: prevention of adverse reactions with corticosteroids.

A gamma-globulin preparation for intravenous use was given to 11 patients with antibody deficiency syndromes. Most of them had reacted earlier to intramuscular injections of normal gamma-globulin. The gamma-globulin employed produced adverse reactions, often quite severe in 8 of 9 intravenous infusions in three patients. After premedication with hydrocortisone, side effects appeared on 18 of 48 occasions in 10 patients, but only twice were they so severe that the infusions had to be interrupted. Thus, it seems that hydrocortisone diminishes the risk of side effects. The intravenously administered gamma-globulin seemed to be just as effective as the preparations for intramuscular use, and no severe infections appeared during the period of observation. There was no indication that the single hydrocortisone injections, usually 200 mg, increased the risk of contracting infections, but still such medication should be used with great caution in antibody-deficient patients.