[PAGID] IVIG and aseptic meningitis

[Routes, John]

Chrus
If sc IgG is truly out of the question would try giving smaller dose with
more frequent infusion--give IVIG to every two weeks rather than every four.
If the infusion rate was high, may also want to give the IVIG over a longer
period of time----finally, I would also give a small dose of IV steroids
(say 50 mg hydrocortisone) prior to the infusion
Jack




John M. Routes, MD
Chief, Section of Allergy and Clinical Immunology
Professor of Pediatrics, Medicine, Microbiology and Molecular Genetics
Department of Pediatrics
Children's Hospital of Wisconsin
Medical College of Wisconsin
9000 W. Wisconsin Ave.
Milwaukee, WI  53226-4874
 
Phone: 414-456-4802; 456-4803
Fax: 414-456-6323 
Email: jroutes at mcw.edu
 




> From: Chris Seroogy <cmseroogy at pediatrics.wisc.edu>

> Reply-To: <pagid at list.clinimmsoc.org>

> Date: Wed, 5 Dec 2007 09:21:00 -0600

> To: "pagid at list.clinimmsoc.org" <pagid at list.clinimmsoc.org>

> Conversation: IVIG and aseptic meningitis

> Subject: [PAGID] IVIG and aseptic meningitis

> 

> 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

> 

> 

>