[PAGID] IVIG and endogenous antibody production

[Chinen, Javier]

If the vaccine is given when the patient who is receiving IVIg has IgG levels at normal range (i.e. not right after infusions), and provided the patient has recovered immunity, as in post BMT, we have documented titer increases to diphttheria, tetanus, pneumococcus that due to their magnitude cannot be attributed to IVIg (data to be presented at the next CIS PIDD meeting). 
We believe that to have one answer the question should include the IVIg dose (supplementation vs anti-inflammatory) and how long after infusion, considering the kinetics and half-life time of Ig. 
.
Javier



From: raas0027 at umn.edu [raas0027 at umn.edu]
Sent: Tuesday, April 27, 2010 5:18 PM
To: pagid at list.clinimmsoc.org
Subject: [PAGID] IVIG and endogenous antibody production

Hello everyone,

I am struggling to find data or literature (e.g. through OVID, PubMed)
supporting the following statements that I find repeatedly in
textbooks/journal review articles:


1. administration of passive antibodies [e.g. IVIG] to antigens that a
patient has not previously encountered can suppress his or her endogenous
capacity to produce antibodies


or in numerous patient-oriented websites:


2. '...If your child is receiving IVIG, there is a risk that it may
interfere with the effectiveness of certain vaccines, even causing the
vaccine to fail.'


Although these seem plausible, are any of you aware of published studies
that demonstrate this with IVIG? I would love to read them.

I would also be interested in anecdotal comments.


Thanks,

Jason

--
Jason Raasch, MD

Midwest Immunology Clinic
15700 37th Ave N
Suite 110
Plymouth, MN 55446

(Phone) 763.577.0008
(FAX)   763.5770192
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