Intravenous gamma globulin administration to common variable immunodeficient women during pregnancy: case report and review of the literature.

Women with common variable immunodeficiency have decreased serum concentrations of all immunoglobulin isotypes. Their offspring are at a high risk for the development of neonatal infection caused by the minimal quantity of maternal immunoglobulin G (IgG) transplacentally transported during pregnancy. These patients are usually given frequent doses of exogenous IgG during the third trimester to increase the amount of IgG transported to the fetus. In this article, we describe the results of initiating a therapeutic regimen of high doses (400 mg/kg) of intravenous gamma globulin every 3 weeks starting in the first trimester of pregnancy for a woman with common variable immunodeficiency. In contrast to most reports, this regimen enables the patient to attain high serum IgG levels early in pregnancy, thereby decreasing the possibility of perinatal sepsis. In addition, the need for frequent administration of intravenous gamma globulin during the third trimester is bypassed with the attainment of protective IgG concentrations in the newborn infant.