Skip to main content
Clinical and Experimental Immunology logoLink to Clinical and Experimental Immunology
. 1986 Sep;65(3):683–690.

Intravenous gammaglobulin for immunodeficiency: report from The European Group for Immunodeficiencies (EGID).

PMCID: PMC1542496  PMID: 2430746

Abstract

Physicians treating patients with antibody deficiency now have a choice between intravenous (IVIG) and intramuscular immunoglobulin therapy. The published comparative trials suggest that (IVIG) is superior, and this is supported by numerous anecdotal observations. Reactions during infusions are no longer a major problem, but there is concern over the transmission of viruses, particularly those causing non-A non-B hepatitis. Having solved the technical difficulties of bulk manufacture of IgG concentrates for intravenous use, our attention should now be directed towards preventing viral contamination by both modifying the manufacturing processes and screening the donors for evidence of disease.

Full text

PDF
683

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ammann A. J., Ashman R. F., Buckley R. H., Hardie W. R., Krantmann H. J., Nelson J., Ochs H., Stiehm E. R., Tiller T., Wara D. W. Use of intravenous gamma-globulin in antibody immunodeficiency: results of a multicenter controlled trial. Clin Immunol Immunopathol. 1982 Jan;22(1):60–67. doi: 10.1016/0090-1229(82)90022-8. [DOI] [PubMed] [Google Scholar]
  2. BARANDUN S., KISTLER P., JEUNET F., ISLIKER H. Intravenous administration of human gamma-globulin. Vox Sang. 1962;7:157–174. doi: 10.1111/j.1423-0410.1962.tb03240.x. [DOI] [PubMed] [Google Scholar]
  3. Bamber M., Murray A., Arborgh B. A., Scheuer P. J., Kernoff P. B., Thomas H. C., Sherlock S. Short incubation non-A, non-B hepatitis transmitted by factor VIII concentrates in patients with congenital coagulation disorders. Gut. 1981 Oct;22(10):854–859. doi: 10.1136/gut.22.10.854. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Björkander J., Bake B., Oxelius V. A., Hanson L. A. Impaired lung function in patients with IgA deficiency and low levels of IgG2 or IgG3. N Engl J Med. 1985 Sep 19;313(12):720–724. doi: 10.1056/NEJM198509193131203. [DOI] [PubMed] [Google Scholar]
  5. Björkander J., Wadsworth C., Hanson L. A. 1040 prophylactic infusions with an unmodified intravenous immunoglobulin product causing few side-effects in patients with antibody deficiency syndromes. Infection. 1985 May-Jun;13(3):102–110. doi: 10.1007/BF01642867. [DOI] [PubMed] [Google Scholar]
  6. Bradley D. W., Maynard J. E., Cook E. H., Ebert J. W., Gravelle C. R., Tsiquaye K. N., Kessler H., Zuckerman A. J., Miller M. F., Ling C. Non-A/non-B hepatitis in experimentally infected chimpanzees: cross-challenge and electron microscopic studies. J Med Virol. 1980;6(3):185–201. doi: 10.1002/jmv.1890060302. [DOI] [PubMed] [Google Scholar]
  7. Brown M. B., Cassell G. H., Taylor-Robinson D., Shepard M. C. Measurement of antibody to Ureaplasma urealyticum by an enzyme-linked immunosorbent assay and detection of antibody responses in patients with nongonococcal urethritis. J Clin Microbiol. 1983 Feb;17(2):288–295. doi: 10.1128/jcm.17.2.288-295.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Buckley R. H. Plasma therapy in immunodeficiency diseases. Am J Dis Child. 1972 Sep;124(3):376–381. doi: 10.1001/archpedi.1972.02110150074014. [DOI] [PubMed] [Google Scholar]
  9. Eibl M. M., Cairns L., Rosen F. S. Safety and efficacy of a monomeric, functionally intact intravenous IgG preparation in patients with primary immunodeficiency syndromes. Clin Immunol Immunopathol. 1984 Apr;31(1):151–160. doi: 10.1016/0090-1229(84)90200-9. [DOI] [PubMed] [Google Scholar]
  10. Evans E. B., Pollock T. M., Cradock-Watson J. E., Ridehalgh M. K. Human anti-chickenpox immunoglobulin in the prevention of chickenpox. Lancet. 1980 Feb 16;1(8164):354–356. doi: 10.1016/s0140-6736(80)90897-1. [DOI] [PubMed] [Google Scholar]
  11. Furusho K., Kamiya T., Nakano H., Kiyosawa N., Shinomiya K., Hayashidera T., Tamura T., Hirose O., Manabe Y., Yokoyama T. High-dose intravenous gammaglobulin for Kawasaki disease. Lancet. 1984 Nov 10;2(8411):1055–1058. doi: 10.1016/s0140-6736(84)91504-6. [DOI] [PubMed] [Google Scholar]
  12. Hermans P. E., Diaz-Buxo J. A., Stobo J. D. Idiopathic late-onset immunoglobulin deficiency. Clinical observations in 50 patients. Am J Med. 1976 Aug;61(2):221–237. doi: 10.1016/0002-9343(76)90173-x. [DOI] [PubMed] [Google Scholar]
  13. Jones R. J., Roe E. A., Gupta J. L. Controlled trial of Pseudomonas immunoglobulin and vaccine in burn patients. Lancet. 1980 Dec 13;2(8207):1263–1265. doi: 10.1016/s0140-6736(80)92334-x. [DOI] [PubMed] [Google Scholar]
  14. Kornhuber B. A retrospective study of immunoglobulin treatment as part of a multi-factorial therapy in children with acute lymphatic leukemia. Arzneimittelforschung. 1981;31(11):1930–1931. [PubMed] [Google Scholar]
  15. Lever A. M., Gross J., Webster A. D. Serum factors for opsonisation of non-typable Haemophilus influenzae. J Med Microbiol. 1985 Aug;20(1):33–38. doi: 10.1099/00222615-20-1-33. [DOI] [PubMed] [Google Scholar]
  16. Lever A. M., Webster A. D., Brown D., Thomas H. C. Non-A, non-B hepatitis occurring in agammaglobulinaemic patients after intravenous immunoglobulin. Lancet. 1984 Nov 10;2(8411):1062–1064. doi: 10.1016/s0140-6736(84)91506-x. [DOI] [PubMed] [Google Scholar]
  17. Mease P. J., Ochs H. D., Wedgwood R. J. Successful treatment of echovirus meningoencephalitis and myositis-fasciitis with intravenous immune globulin therapy in a patient with X-linked agammaglobulinemia. N Engl J Med. 1981 May 21;304(21):1278–1281. doi: 10.1056/NEJM198105213042107. [DOI] [PubMed] [Google Scholar]
  18. Morell A., Schürch B., Ryser D., Hofer F., Skvaril F., Barandun S. In vivo behaviour of gamma globulin preparations. Vox Sang. 1980;38(5):272–283. doi: 10.1111/j.1423-0410.1980.tb02367.x. [DOI] [PubMed] [Google Scholar]
  19. Munro C. S., Stanley P. J., Cole P. J. Assessment of biological activity of immunoglobulin preparations by using opsonized micro-organisms to stimulate neutrophil chemiluminescence. Clin Exp Immunol. 1985 Jul;61(1):183–188. [PMC free article] [PubMed] [Google Scholar]
  20. Musher D. M., Hague-Park M., Baughn R. E., Wallace R. J., Jr, Cowley B. Opsonizing and bactericidal effects of normal human serum on nontypable Haemophilus influenzae. Infect Immun. 1983 Jan;39(1):297–304. doi: 10.1128/iai.39.1.297-304.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Non-A, non-B hepatitis and intravenous immunoglobulin. Lancet. 1985 Feb 16;1(8425):404–405. [PubMed] [Google Scholar]
  22. Ochs H. D., Fischer S. H., Wedgwood R. J., Wara D. W., Cowan M. J., Ammann A. J., Saxon A., Budinger M. D., Allred R. U., Rousell R. H. Comparison of high-dose and low-dose intravenous immunoglobulin therapy in patients with primary immunodeficiency diseases. Am J Med. 1984 Mar 30;76(3A):78–82. doi: 10.1016/0002-9343(84)90324-3. [DOI] [PubMed] [Google Scholar]
  23. Roe E. A., Jones R. J. Immunization of burned patients against Pseudomonas aeruginosa infection at Safdarjang Hospital, New Delhi. Rev Infect Dis. 1983 Nov-Dec;5 (Suppl 5):S922–S930. doi: 10.1093/clinids/5.supplement_5.s922. [DOI] [PubMed] [Google Scholar]
  24. Roord J. J., van der Meer J. W., Kuis W., van Furth R. Treatment of antibody deficiency syndromes with subcutaneous infusion of gamma globulin. Birth Defects Orig Artic Ser. 1983;19(3):217–221. [PubMed] [Google Scholar]
  25. Römer J., Morgenthaler J. J., Scherz R., Skvaril F. Characterization of various immunoglobulin preparations for intravenous application. I. Protein composition and antibody content. Vox Sang. 1982 Feb;42(2):62–73. doi: 10.1159/000460850. [DOI] [PubMed] [Google Scholar]
  26. SOLOMON A., WALDMANN T. A., FAHEY J. L. Clinical and experimental metabolism of normal 6.6s gamma-globulin in normal subjects and in patients with macroglobulinemia and multiple myeloma. J Lab Clin Med. 1963 Jul;62:1–17. [PubMed] [Google Scholar]
  27. Skvaril F., Probst M., Audran R., Steinbuch M. Distribution of IgG subclasses in commercial and some experimental gamma-globulin preparations. Vox Sang. 1977;32(6):335–338. doi: 10.1111/j.1423-0410.1977.tb00655.x. [DOI] [PubMed] [Google Scholar]
  28. So A., Brenner M. K., Hill I. D., Asherson G. L., Webster A. D. Intravenous gammaglobulin treatment in patients with hypogammaglobulinaemia. Br Med J (Clin Res Ed) 1984 Nov 3;289(6453):1177–1178. doi: 10.1136/bmj.289.6453.1177. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Tovo P. A., Gabiano C., Grazia Roncarolo M., Altare F. IgE content of commercial intravenous IgG preparations. Lancet. 1984 Feb 25;1(8374):458–458. doi: 10.1016/s0140-6736(84)91797-5. [DOI] [PubMed] [Google Scholar]
  30. Ugazio A. G., Duse M., Re R., Mangili G., Burgio G. R. Subcutaneous infusion of gammaglobulins in management of agammaglobulinaemia. Lancet. 1982 Jan 23;1(8265):226–226. doi: 10.1016/s0140-6736(82)90793-0. [DOI] [PubMed] [Google Scholar]
  31. Vyas G. N., Perkins H. A., Fudenberg H. H. Anaphylactoid transfusion reactions associated with anti-IgA. Lancet. 1968 Aug 10;2(7563):312–315. doi: 10.1016/s0140-6736(68)90527-8. [DOI] [PubMed] [Google Scholar]
  32. Waldmann T. A., Strober W. Metabolism of immunoglobulins. Prog Allergy. 1969;13:1–110. doi: 10.1159/000385919. [DOI] [PubMed] [Google Scholar]
  33. Webster A. D., Dalgleish A. G., Malkovsky M., Beattie R., Patterson S., Asherson G. L., North M., Weiss R. A. Isolation of retroviruses from two patients with "common variable" hypogammaglobulinaemia. Lancet. 1986 Mar 15;1(8481):581–583. doi: 10.1016/s0140-6736(86)92809-6. [DOI] [PubMed] [Google Scholar]
  34. Webster A. D., Taylor-Robinson D., Furr P. M., Asherson G. L. Mycoplasmal (ureaplasma) septic arthritis in hypogammaglobulinaemia. Br Med J. 1978 Feb 25;1(6111):478–479. doi: 10.1136/bmj.1.6111.478. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Webster A. D. The gut and immunodeficiency disorders. Clin Gastroenterol. 1976 May;5(2):323–340. [PubMed] [Google Scholar]
  36. van Furth R., Leijh P. C., Klein F. Correlation between opsonic activity for various microorganisms and composition of gammaglobulin preparations for intravenous use. J Infect Dis. 1984 Apr;149(4):511–517. doi: 10.1093/infdis/149.4.511. [DOI] [PubMed] [Google Scholar]

Articles from Clinical and Experimental Immunology are provided here courtesy of British Society for Immunology

RESOURCES