Intravenous Immunoglobulin (IVIG) is a medical treatment derived from human plasma. This article explores the relationship between IVIG therapy and liver health, addressing concerns about potential liver damage.
What is Intravenous Immunoglobulin (IVIG)?
IVIG is a therapeutic product made from the pooled plasma of thousands of healthy blood donors. This plasma contains a concentrated collection of antibodies, primarily immunoglobulin G (IgG). IVIG is administered directly into a patient’s vein.
The main purpose of IVIG is to treat a range of immune deficiencies and autoimmune disorders. It works by providing antibodies to individuals whose bodies do not produce enough, or by modulating the immune system’s response in autoimmune conditions.
IVIG’s Potential Impact on the Liver
IVIG can be associated with temporary changes in liver enzyme levels. These changes, known as transaminitis, involve elevations in alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Such elevations are often mild and do not usually present with noticeable symptoms.
Severe liver damage from IVIG is extremely rare. When liver enzyme elevations occur, they are frequently transient, resolving on their own after treatment stops. Some research suggests these temporary increases might be linked to specific stabilizing agents, such as maltose, used in certain IVIG formulations.
Recognizing Signs of Liver Involvement During IVIG Therapy
Patients receiving IVIG therapy should be aware of signs of liver involvement. Symptoms can include fatigue, nausea, dark urine, or yellowing of the skin and eyes (jaundice).
Abdominal pain, particularly in the upper right side where the liver is located, could also signal a liver issue. Report any new or unusual symptoms to your healthcare provider promptly for timely assessment and management.
Managing and Monitoring Liver Health with IVIG
Healthcare providers conduct pre-treatment screening before IVIG therapy begins. This includes baseline liver function tests to establish a patient’s normal enzyme levels. During and after IVIG infusions, regular monitoring of liver enzymes, such as ALT and AST, is standard practice. These tests help detect changes early, often before symptoms appear.
Certain factors can increase susceptibility to liver enzyme elevations, including pre-existing liver conditions or other medications. If abnormalities in liver function tests are detected, the medical team will evaluate the situation. They may consider adjusting the IVIG dosage, altering the infusion rate, or exploring alternative treatment options, always balancing benefits against potential risks.