[PAGID] IVIG and aseptic meningitis

[HOWARD M LEDERMAN]

My first step would be to consider which product is being used.  Sometimes a change from a lyophilized product (e.g., Carimune) to a product supplied as a ready-to-infuse liquid can eliminate this problem.

My next step would be to use 50-100 mg of hydrocortisone as a pre-med.

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


----- Original Message -----
From: Chris Seroogy <cmseroogy at pediatrics.wisc.edu>
Date: Wednesday, December 5, 2007 10:21 am
Subject: [PAGID] IVIG and aseptic meningitis
To: "pagid at list.clinimmsoc.org" <pagid at list.clinimmsoc.org>



> Dear Colleagues,

>  

>  I have a question about management of aseptic meningitis and IVIG.

>  

>  We have a 5 y/o with chemotherapy-induced immunodeficiency who meets

>  criteria for immunoglobulin replacement.  He just had his first infusion

>  (400mg/kg gammagard S/D) which went well, but 48 hours later developed

>  severe headache and stiff neck.  I did not evaluate him, but the heme/onc

>  colleagues felt he had aseptic meningitis and this resolved with pain

>  management.

>  

>  My question is what has worked for individuals to prevent/prophylaxis 

> this

>  side effect?  He needs the product and I am told subcutaneous is not 

> an

>  option since he will pull out the tubing and it would be too much of 

> a time

>  commitment for the family.  Thank you for any input!  Regards, Chris

>  

>  

>