Adverse reactions in a large cohort of patients with inborn errors of immunity receiving intravenous immunoglobulin,Clinical Immunology

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Adverse reactions in a large cohort of patients with inborn errors of immunity receiving intravenous immunoglobulin
Clinical Immunology ( IF 4.5 ) Pub Date : 2021-08-19 , DOI: 10.1016/j.clim.2021.108826
Hossein Esmaeilzadeh ₁ , Aida Askarisarvestani ₂ , Nazanin Hosseini ₃ , Sahar Samimi ₄ , Alireza Shafiei ₅ , Seyed Alireza Mahdaviani ₆ , Narges Eslami ₇ , Zahra Chavoshzadeh ₇ , Mazdak Fallahi ₇ , Nasrin Khakbazanfard ₇ , Mahnaz Sadeghi Shabestari ₈ , Soheila Aleyasin ₁ , Seyed Hesamedin Nabavizadeh ₁ , Taher Cheraghi ₉ , Arash Kalantari ₁₀ , Akefeh Ahmadiafshar ₁₁ , Mojgan Safari ₁₂ , Mohammad Hossein Eslamian ₁₂ , Rasol Molatefi ₁₃ , Afshin Shirkani ₁₄ , Marzieh Heidarzadeh Arani ₁₅ , Marzieh Tavakol ₁₆ , Mohammad Hassan Bemanian ₁₇ , Saba Arshi ₁₇ , Mohammad Nabavi ₁₇ , Sima Shokri ₁₇ , Babak Shahhosseini ₂ , Negar Mortazavi ₁₈ , Pooria Nakhaei ₃ , Farzad Nazari ₄ , Morteza Fallahpour ₁₇ , Hamid Ahanchian ₁₉ , Nasrin Moazzen ₁₉ , Maryam Khoshkhui ₁₉ , Ahmad Vosughi Motlagh ₂₀ , Asghar Aghamohammadi ₄ , Hassan Abolhassani ₂₁ , Reza Yazdani ₄ , Nima Rezaei ₄

Affiliation

Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Division of Allergy and Clinical Immunology, Pediatrics Department, Shiraz University of Medical Sciences, Shiraz, Iran.
Division of Allergy and Clinical Immunology, Pediatrics Department, Shiraz University of Medical Sciences, Shiraz, Iran.
Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Primary Immunodeficiency Diseases Network (PIDNet), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
Division of Allergy and Clinical Immunology, Department of Pediatrics, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Allergy and Clinical immunology Dept, Mofid Children Hospital, , Shahid Beheshti University of Medical Sciences, Tehran, , Iran.
Department of Immunology and Allergy, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Pediatrics, 17th Shahrivar Children's Hospital, Guilan University of Medical Sciences, Rasht, Iran.
Department of Immunology and Allergy, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran.
Department of Pediatrics, Hamadan University of Medical Sciences, Hamadan, Iran.
Department of Pediatrics, Bo-Ali children's Hospital of Ardabil University of Medical Sciences, Ardabil, Iran.
Allergy and Clinical Immunology Department, Bushehr University of Medical Science, School of Medicine, Bushehr, Iran.
Pediatric Department, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
Department of Allergy and Clinical Immunology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Department of Clinical Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Pediatrics, North Khorasan University of Medical Sciences, Bojnurd. Iran.
Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Division of Clinical Immunology, Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden; Division of Clinical Immunology, Department of Laboratory Medicine, Karolinska Institute at Karolinska University Hospital Huddinge, Stockholm, Sweden; Primary Immunodeficiency Diseases Network (PIDNet), Universal Scientific Education and Research Network (USERN), Tehran, Iran.

Background

Intravenous immunoglobulins (IVIg) are the major treatment in inborn errors of immunity (IEI) disorders; However, IVIg infusions show some adverse effects. We aimed to assess the adverse reactions of IVIg infusions.

Methods

Data of IVIg infusions in IEI patients were collected from 2011 to 2021. Totally, 363 IEI patients received IVIg regularly in Iran entered the study. The adverse reactions are classified regarding their severity and chronicity.

Results

22,667 IVIg infusions were performed in the study. 157 patients (43.2%) and 1349 (5.9%) infusions were associated with at least one type of adverse reaction. The highest rates of adverse reactions were seen in severe combined immunodeficiency. Myalgia, chills, headache, fever, and hypotension were the most frequent adverse effects of IVIg.

Conclusion

The reactions affect almost half of the patients mainly in the first infusions which necessitate the close observation of IEI patients receiving IVIg.

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