Intravenous Immunoglobulin (IVIG) therapy involves administering antibodies, known as immunoglobulins, directly into a patient’s vein. These antibodies are derived from the plasma of healthy donors and serve to bolster or modulate the immune system. IVIG is used to treat a wide array of conditions, including primary immunodeficiencies, certain autoimmune disorders, and neurological conditions, by providing the body with necessary protective proteins. IVIG therapy can lead to various side effects, and understanding these potential reactions is important.
Common Reactions
Many individuals receiving IVIG therapy experience mild and temporary side effects. These reactions typically emerge during the infusion or within a few hours afterward. Headaches are among the most frequently reported common reactions, ranging from mild discomfort to more noticeable pain. Some patients may also develop a transient fever, accompanied by chills or a feeling of flushing.
Muscle aches, particularly in the back or joints, can occur as the body adjusts to the infusion. Fatigue and a general sense of malaise are also common, often subsiding within a day or two. Gastrointestinal disturbances such as nausea, vomiting, or abdominal discomfort might also be experienced during or shortly after the infusion. Dizziness or lightheadedness, usually mild, can also occur.
These common reactions are generally manageable and do not typically necessitate stopping the treatment. Healthcare providers often recommend slowing the infusion rate or administering pre-medications like acetaminophen, antihistamines, or corticosteroids to help mitigate these symptoms. Most of these mild side effects resolve on their own as the body processes the immunoglobulin.
Serious Reactions
Less common but serious reactions can occur during or after IVIG infusion. Anaphylaxis, a severe and potentially life-threatening allergic reaction, is a rare but serious concern. Symptoms can include difficulty breathing, wheezing, hives, a sudden drop in blood pressure, and swelling of the face or throat. Such reactions necessitate immediate cessation of the infusion and emergency medical intervention.
Kidney problems, specifically acute renal dysfunction, can manifest, particularly in patients with pre-existing kidney issues or those receiving formulations containing sucrose. This can lead to decreased urine output, swelling, and a rise in blood creatinine levels. Blood clots, or thrombotic events, are another possible serious complication, which can affect various parts of the body such as the brain (stroke), heart (heart attack), or lungs (pulmonary embolism). Risk factors for blood clots include advanced age, immobility, and certain underlying medical conditions.
Aseptic meningitis, characterized by inflammation of the membranes surrounding the brain and spinal cord without bacterial infection, can also occur. Symptoms typically include a severe headache, stiff neck, fever, and sensitivity to light. Hemolytic anemia, where red blood cells are prematurely destroyed, may develop, leading to symptoms like fatigue, pale skin, and dark urine. Transfusion-related acute lung injury (TRALI) is another rare but severe complication, presenting with sudden breathing difficulties and fluid in the lungs, typically within hours of the infusion.
Managing Reactions and When to Seek Medical Attention
Maintaining good hydration before, during, and after the infusion is often recommended. Healthcare providers may prescribe pre-medications, such as acetaminophen or antihistamines, to be taken before the infusion to reduce the likelihood or severity of common reactions. Communicating openly with the healthcare team about any past reactions or current symptoms is also important.
For mild, common reactions like a headache or muscle aches, resting and using over-the-counter pain relievers, if approved by a doctor, can provide relief. If symptoms are bothersome, the infusion rate can sometimes be temporarily slowed down under medical supervision, which often helps alleviate discomfort. These adjustments are typically made by the nursing staff administering the infusion.
Patients should contact their healthcare provider if common side effects persist, worsen, or if new or unusual symptoms develop that cause concern. This includes any symptoms that are not typical for a mild infusion reaction or those that significantly impact daily activities. Prompt communication ensures that the care team can assess the situation and provide appropriate guidance.
Seek emergency medical attention immediately for any severe symptoms, such as difficulty breathing, hives, sudden weakness, chest pain, vision changes, slurred speech, or a severe headache with a stiff neck. These symptoms may signal potentially life-threatening conditions like a blood clot, stroke, or aseptic meningitis.