Complications of Immunoglobulin Therapy and Implications for Treatment of Inflammatory Neuropathy: A Review

Curr Drug Saf. 2019;14(1):3-13. doi: 10.2174/1574886313666181017121139.

Abstract

Background: Intravenous Immunoglobulin (IVIg) forms a cornerstone of effective treatment for acute and chronic inflammatory neuropathies, with a class I evidence base in Guillain-Barré Syndrome (GBS), Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) and multifocal motor neuropathy (MMN). It is generally considered to be a safe therapy however there are several recognised complications which are reviewed in this article.

Discussion and conclusion: Most adverse events are immediate and mild such as headache, fever and nausea although more serious immediate reactions such as anaphylaxis may rarely occur. Delayed complications are rare but may be serious, including thromboembolic events and acute kidney injury, and these and associated risk factors are also discussed. We emphasise the importance of safe IVIg administration and highlight practical measures to minimise complications of this therapy.

Keywords: Adverse event; CIDP; GBS; IVIg; MMN; immunoglobulin; inflammatory neuropathy; safety..

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / chemically induced
  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / immunology
  • Fever / chemically induced
  • Fever / diagnosis
  • Fever / immunology
  • Guillain-Barre Syndrome / diagnosis
  • Guillain-Barre Syndrome / drug therapy*
  • Guillain-Barre Syndrome / immunology
  • Headache / chemically induced
  • Headache / diagnosis
  • Headache / immunology
  • Humans
  • Immunization, Passive / adverse effects*
  • Immunization, Passive / methods
  • Immunoglobulins, Intravenous / administration & dosage
  • Immunoglobulins, Intravenous / adverse effects*
  • Nausea / chemically induced
  • Nausea / diagnosis
  • Nausea / immunology
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / diagnosis
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / drug therapy*
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / immunology
  • Treatment Outcome

Substances

  • Immunoglobulins, Intravenous