[PAGID] IVIG and aseptic meningitis

[Anita Gewurz]

Chris,

SC gammaglobulin (SCGG) would avoid the problem.  If you have a young  
child on SCGG who could show your patient how it works, he might be  
less fearful of it.  Any local discomfort with initial infusions can  
be minimized with topical lidocaine and lower starting doses.  As Mel  
Berger and others will tell you, the infusion can be completed while  
the patient watches a video, does homework or sleeps and can go with  
him on vacation trips.   Quality-of-life is better for the whole  
family and so are trough IgGs.

Good luck!

Anita

Anita Gewurz MD <agewurz at rush.edu>
Section of Allergy/Immunology
Department of
Immunology/Microbiology
Rush University Medical Center
1725 W Harrison - 117
Chicago IL 60612
TEL (312) 942-6296
VM  (312) 942-4912
FAX (312) 563-2201
PAGER/CELL (847) 224-8550




On Dec 5, 2007, at 9:21 AM, Chris Seroogy wrote:


> 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

>

>

>


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