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Intranenous and Subcutaneous Immunoglobulin in Primary Immunodeficiency

What is Immunoglobulin

Immunoglobulin is a protein in human plasma. It is found in all of us except few who are immunodeficient. Those patients who don’t have enough of immunoglobulin (hypogammaglobulinemia) or where it doesn’t work well (functional antibody deficiency); replacing it in adequate amounts help fight variety of infections.

Patients who have inflammation in body also benefit from immunoglobulin use in selected diseases.

How Is Immunoglobulin Made?

It is made from pooled human plasma and was first available during World War II. Currently, plasma from thousands of screened donors is pooled and subjected to various processes to make it safe from transmitting virus, bacteria and to decrease any side effects.

What Does Immunoglobulin Contain?

More than 95% of final preparation is immunoglobulin IgG. It doesn’t contain much IgA or IgM immunoglobulin.

Immunoglobulin Use

FDA has approved use of immunoglobulin for the following conditions:

  • Primary immunodeficiency
  • Immune thrombocytopenia
  • Secondary immunodeficiency in CLL
  • Pediatric HIV infections
  • Chronic inflammatory demyelinating polyneuropathy
  • Kawasaki syndrome

Use in Primary or Acquired Hypogammaglobulinemia

Immunoglobulin treatment is used in many primary immune deficiency states

  1. B-cell immune deficiency.
    • agammaglobulinemia
    • common variable hypogammaglobulinemia
    • Hyper-IgM syndrome
  2. Severe combined immunodeficiency (SCID) used in patients who have yet not gone under stem cell transplant or up to one year, occasionally lifelong, after hematopoietic stem cell transplant (HCT).
  3. Other specific immune disorders
    • Wiskott-Aldrich syndrome
    • DiGeorge syndrome
    • Functional antibody deficiency