Hemolysis upon intravenous immunoglobulin transfusion

Transfus Apher Sci. 2012 Feb;46(1):93-6. doi: 10.1016/j.transci.2011.11.004. Epub 2011 Dec 13.


Intravenous immunoglobulin (IVIG) is a mainstay of therapy in many disorders. An uncommon adverse side effect is IVIG-related hemolysis. Risk factors for IVIG-related hemolysis have been identified, including high dose IVIG given to non-O blood group recipients with an underlying inflammatory state. IVIG-related hemolysis has been linked to anti-A and anti-B hemagglutinins in the IVIG preparations and may involve both IgG and complement mediated hemolysis. A two-hit mechanism with threshold effect is proposed for IVIG-related hemolysis. Strategies exist to minimize or avoid IVIG-related hemolysis.

Publication types

  • Review

MeSH terms

  • Complement System Proteins / immunology
  • Complement System Proteins / metabolism
  • Hemagglutinins / blood
  • Hemagglutinins / immunology
  • Hemolysis / drug effects*
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin G / immunology
  • Immunoglobulins, Intravenous / adverse effects*
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunologic Factors / adverse effects*
  • Immunologic Factors / therapeutic use
  • Risk Factors


  • Hemagglutinins
  • Immunoglobulin G
  • Immunoglobulins, Intravenous
  • Immunologic Factors
  • Complement System Proteins