[CIS PIDD] ScIg & REnal impairment

[raas0027 at umn.edu]

Quick question:

Has anyone noted impaired kidney function (using increased serum creatinine 
as a 'marker') with subcutaneous immunoglobulin?


Background:

I have a patient that I care for who lives a few hundred miles from our 
clinic. Older gentleman, complex medical history including CVID, lymphoma, 
chemotherapy, heart disease. Has had a creatinine above 1.2 and as high as 
2.4 for a few years (before ScIg).

He calls reporting a temporal relationship (increase in creatinine) with 
Hizentra administration (e.g. administers ScIg one day, creatinine goes 
from
1.2 to up to above 2.0 the next day).

I cannot conceive of a mechanism for why this might occur with SUBCUTANEOUS 
IgG (IVIG, yes; ScIg, no). His other specialists are convinced its the ScIg 
and advising him to discontinue. (?!)

I performed a literature search and found no case reports.  

I am very dubious of the proposed CAUSAL relationship but before I take 
such a stance I would like your observations about this.

Thanks.

-J

P.S. Thanks to all regarding your comments about primary immune deficiency 
and alpha-1 antitrypsin deficiency.



-- 
Jason Raasch, MD

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

(Phone) 763.577.0008
(FAX)   763.5770192