Risks of Intravenous Immunoglobulin in Sepsis Affect Trial Design
Authors: Sujoy Khan, W. A.C. Sewell
Journal: Annals of Internal Medicine (2007)

Letters4 December 2007Risks of Intravenous Immunoglobulin in Sepsis Affect Trial DesignSujoy Khan, MBBS and W. A.C. Sewell, MBBS, PhDSujoy Khan, MBBSFrom Path Links Immunology, Scunthorpe DN15 7BH, United Kingdom.Search for more papers by this author and W. A.C. Sewell, MBBS, PhDFrom Path Links Immunology, Scunthorpe DN15 7BH, United Kingdom.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-11-200712040-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The meta-analysis by Turgeon and colleagues (1) on the use of intravenous immunoglobulin (IVIG) in adults with sepsis suggests that larger trials should be performed incorporating modern sepsis management techniques. However, the authors did not discuss the side effects of using IVIG in sepsis.All immunologists recognize that immunoglobulin replacement therapy must be withheld in patients with infections because severe reactions commonly develop (2). An audit of adverse reactions in antibody-deficient patients showed that an intercurrent infection was the major cause of reactions to IVIG replacement therapy (3). This multicenter prospective study of 459 patients reported that ...References1. Turgeon AF, Hutton B, Fergusson DA, McIntyre L, Tinmouth AA, Cameron DW, et al. Meta-analysis: intravenous immunoglobulin in critically ill adult patients with sepsis. Ann Intern Med. 2007;146:193-203. [PMID: 17283351] LinkGoogle Scholar2. Orange JS, Hossny EM, Weiler CR, Ballow M, Berger M, Bonilla FA, et al. Use of intravenous immunoglobulin in human disease: a review of evidence by members of the Primary Immunodeficiency Committee of the American Academy of Allergy, Asthma and Immunology. J Allergy Clin Immunol. 2006;117:S525-53. [PMID: 16580469] CrossrefMedlineGoogle Scholar3. Brennan VM, Salomé-Bentley NJ, Chapel HM; Immunology Nurses Study. Prospective audit of adverse reactions occurring in 459 primary antibody-deficient patients receiving intravenous immunoglobulin. Clin Exp Immunol. 2003;133:247-51. [PMID: 12869031] CrossrefMedlineGoogle Scholar4. Rodríguez A, Rello J, Neira J, Maskin B, Ceraso D, Vasta L, et al. Effects of high-dose of intravenous immunoglobulin and antibiotics on survival for severe sepsis undergoing surgery. Shock. 2005;23:298-304. [PMID: 15803051] CrossrefMedlineGoogle Scholar5. von Gunten S, Schaub A, Vogel M, Stadler BM, Miescher S, Simon HU. Immunologic and functional evidence for anti-Siglec-9 autoantibodies in intravenous immunoglobulin preparations. Blood. 2006;108:4255-9. [PMID: 16902148] CrossrefMedlineGoogle Scholar6. McGinnity E. Eye on IVIG: a series of unfortunate supply chain events. Healthcare Purchasing News. 2007;31:70-1. Google Scholar Author, Article, and Disclosure InformationAuthors: Sujoy Khan, MBBS; W. A.C. Sewell, MBBS, PhDAffiliations: From Path Links Immunology, Scunthorpe DN15 7BH, United Kingdom.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMeta-analysis: Intravenous Immunoglobulin in Critically Ill Adult Patients with Sepsis Alexis F. Turgeon , Brian Hutton , Dean A. Fergusson , Lauralyn McIntyre , Alan A. Tinmouth , D. William Cameron , and Paul C. Hébert Risks of Intravenous Immunoglobulin in Sepsis Affect Trial Design Alexis F. Turgeon , Dean A. Fergusson , D. William Cameron , Paul C. Hébert , Lauralyn McIntyre , and Alan A. Tinmouth Metrics Cited byGranulocyte Death Regulation by Naturally Occurring AutoantibodiesNatural anti-Siglec autoantibodies mediate potential immunoregulatory mechanisms: Implications for the clinical use of intravenous immunoglobulins (IVIg) 4 December 2007Volume 147, Issue 11Page: 813KeywordsAdverse reactionsAntibioticsForecastingIntravenous immunoglobulinNeutrophilsOxygenProphylaxisProspective studiesQuality of lifeSepsis ePublished: 4 December 2007 Issue Published: 4 December 2007 Copyright & PermissionsCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...