Pediatria pre prax 2/2012

Intravenous immunoglobulins and their immunomodulatory effect in pediatrics

Until the early 1980s, immunoglobulins were indicated exclusively for replacement therapy of primary humoral immunodeficiencies. Recently, there has been a rapid expansion of the use of intravenous immunoglubulins (IVIG) at a high dose (2 g/kg/month) as an 'immunomodulatory' agent in an increasing number of immune and inflammatory disorders. The limitations for IVIG are the cost of the preparation and the need for intravenous infusions. Due to the cost, shortages and growing use of IVIG there have been attempts to develop evidence-based guidelines for the use of IVIG in a wide variety of hematological, autoimmune and neurological conditions. Although IVIG is a safe treatment option when compared with other immunosuppressive agents there needs to be an understanding of the potential adverse reactions and their management. It is important for the physician to carefully assess and monitor patients on IVIG so that treatment can be optimized.

Keywords: intravenous immunoglobulins, IVIG, idiopathic thrombocytopenic purpura, Kawasaki disease, Guillain-Barré syndrome.