[PAGID] IVIG and acute renal failure

[Charles.Kirkpatrick at UCHSC.edu]

-----Original Message-----
From: pagid-bounces at list.clinimmsoc.org
[mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of
Charles.Kirkpatrick at uchsc.edu
Sent: Wednesday, February 28, 2007 8:27 AM
To: pagid at list.clinimmsoc.org
Subject: Re: [PAGID] IVIG and acute renal failure

 

Howard, I now have 20 patients receiving IgG subcutaneously.  We do
random IgG, ALT and creatinine assays at approximately 6 month
intervals.  None of the creatinines have been abnormal during the 8
years that we have been using more SQ IgG.  The average duration of
treatment is over 4 years.

 

On the other hand, one patient with known chronic renal disease who had
a stable creatinine of 3.0 while on IV Gamunex received one infusion of
Polygam because of a shortage of Gamunex.  Her creatinine went to 6.5
and she was dialyzed for about a month before the renal function
recovered (creatinine 3.5).  During the past 2 years the kidney function
has slowly deteriorated and she is back on dialysis.

 

Chuck 

 

-----Original Message-----
From: pagid-bounces at list.clinimmsoc.org
[mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of HOWARD M
LEDERMAN
Sent: Thursday, February 22, 2007 10:59 AM
To: PAGID LISTSERV
Subject: [PAGID] IVIG and acute renal failure

 

I have a newly dx'd 48 y/o CVID who had pre-existing chronic renal
failure of unknown etiology and baseline creatinine of 3.1  We started
IVIG using Gamunex to avoid the high sucrose/high osmolalityIVIG
products.  Nevertheless, his creatinine increased to 5.1 for no other
apparent reason. 

Since I don't know the mechanism by which this occurred, I don't know if
it is related to the specific product or the dose.  Do people feel
comfortable using weekly SQ infusions in this setting?  Any other
thoughts?

Howard 
Howard M. Lederman, M.D., Ph.D. 
Professor of Pediatrics and Medicine 
Division of Pediatric Allergy and Immunology 
Johns Hopkins Hospital - CMSC 1102 
600 N. Wolfe Street 
Baltimore, MD 21287-3923 
Phone:  410-955-5883 
Fax:    410-955-0229 
e-mail: Hlederm1 at jhem.jhmi.edu 

-------------- next part --------------
An HTML attachment was scrubbed...
URL: http://seven.pairlist.net/mailman/private/pagid/attachments/20070228/c43f1f3a/attachment.htm