[PAGID] IVIG reactions

[Belohradsky, Bernd Prof. Dr.]

if he complains about severe local pain under scIgG he might seriously
have a psychosomatic problem; in more than 100 patients, children and
adults, we have never seen this problem ! did you try local anesthetic
ointment ? 
(Bernd H.Belohradsky,MD,Munich)

________________________________

Von: pagid-bounces at list.clinimmsoc.org
[mailto:pagid-bounces at list.clinimmsoc.org] Im Auftrag von Kobrynski,
Lisa
Gesendet: Donnerstag, 15. Januar 2009 04:53
An: pagid at list.clinimmsoc.org
Betreff: [PAGID] IVIG reactions


I need some creative suggestions to help me with a 17 yo CVID patient
This patient develops severe lower back pain with IVIG infusions.  The
back pain usually starts 2-3 hours into the infusion and is not
associated with changes in vital signs.  We have tried 4 different IVIG
preparations, 5%, 10% preparations, slowing the rate of infusion (as low
as 25 cc/hr), premedication with antihistamine, acetaminophen,
ibuprofen, corticosteroids (all together).
We tried SC IG and he complained of severe pain at the sites of infusion
despite changes in needle size and product.
 
He does need some passive immunity, he has lung disease, and IgG is <400
off IVIG.
 
Any suggestions?
 
Lisa Kobrynski, MD, MPH
Associate Professor of Pediatrics
Section, Allergy/Immunology

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