Renal and hematologic side effects of long-term intravenous immunoglobulin therapy in patients with neurologic disorders

Muscle Nerve. 2017 Dec;56(6):1173-1176. doi: 10.1002/mus.25693. Epub 2017 May 30.

Abstract

Introduction: For patients receiving intravenous immunoglobulin (IVIg), renal and hemolytic side effects are well recognized. However, there are very few data on the effects of chronic IVIg therapy.

Methods: We retrospectively analyzed laboratory data on 166 patients who received IVIg for 12 months with a dose range of 0.441-2.58 g/kg/month, measuring changes in hematocrit and glomerular filtration (GFR) rates at 6 and 12 months.

Results: Of the 2,232 infusions, there were no incidents of clinical hemolysis. However, after 12 months of treatment, 21% of patients had a ≥3-g/dl decline in hematocrit and 10% had a ≥20% decline in GFR.

Discussion: No clinically significant hemolysis was observed in patients receiving chronic IVIg therapy. However, a significant number of patients had a decline in hematocrit and/or GFR while on therapy. This emphasizes the need for observation of hematologic and renal function in patients treated with chronic IVIg. Muscle Nerve 56: 1173-1176, 2017.

Keywords: CIDP; IVIg; multiple sclerosis; myasthenia gravis; myositis.

MeSH terms

  • Drug Administration Schedule
  • Drug-Related Side Effects and Adverse Reactions / diagnosis
  • Drug-Related Side Effects and Adverse Reactions / physiopathology
  • Female
  • Glomerular Filtration Rate / drug effects*
  • Glomerular Filtration Rate / physiology
  • Hematocrit / trends
  • Hemolysis / drug effects*
  • Hemolysis / physiology
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage*
  • Immunoglobulins, Intravenous / adverse effects*
  • Kidney Diseases / chemically induced
  • Kidney Diseases / diagnosis
  • Kidney Diseases / physiopathology
  • Male
  • Nervous System Diseases / drug therapy*
  • Nervous System Diseases / physiopathology
  • Retrospective Studies
  • Time Factors

Substances

  • Immunoglobulins, Intravenous