In this procedure, a patient's blood is removed, and then centrifuged to separate the cellular and plasma components. The cellular components are then diluted with artificial plasminate and reinfused into the patient. The therapeutic effect is presumably due to the removal of inciting circulating factors such as antibodies. Because infusion of intravenous immunoglobulin does not entail the difficulties in line placement sometimes encountered with plasmapheresis, and because it can be easily arranged on any time, it is now the first choice of therapy. For both infusions of HIG and plasmapheresis, it is important to check serum immunoglobulin levels.
All commercial products appear to be equally effective, and all are expensive.
The record of safety is excellent, although concern about possible transmission of hepatitis C with one product occurred in 1994. However, since the implementation of new viral inactivation procedure, no case of hepatitis C transmission has been reported in the United States. The two main complications of infusion of HIG are headache and acute renal failure. Headaches are self-limited and may occur more often in migraineurs. The headaches are often associated with a CSF pleocytosis suggesting possible aseptic meningitis.