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A review of current indications, adverse effects, and administration recommendations for intravenous immunoglobulin

Authors

  • Nicole K. Spurlock DVM,

    Corresponding author
    • Department of Emergency and Critical Care, The Animal Medical Center, New York, NY
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  • Jennifer E. Prittie DVM, DACVIM, DACVECC


  • Dr. Prittie is an Assistant Editor for the journal but did not have any input in the peer review process of this manuscript other than as an author. The authors declare no other conflicts of interest.

Address correspondence and reprint requests to

Dr. Nicole Spurlock, Department of Emergency and Critical Care, The Animal Medical Center, 510 E 62nd St, New York, NY 10065, USA.

Email: nicole.spurlock@amcny.org

Abstract

Objective

To review and summarize the body of literature regarding human intravenous immunoglobulin (hIVIG) therapy in veterinary medicine. Mechanism of action, usage in human medicine, adverse effects of therapy, implications for veterinary use, and administration recommendations are discussed.

Data Sources

Current human and veterinary peer-reviewed medical literature including original research articles and scientific reviews.

Human Data Synthesis

There are currently 6 labeled uses for hIVIG in human medicine, but preparations are used off-label to successfully treat multiple immune-mediated conditions. To maximize the potential of hIVIG use in animals and identify areas deficient in research, a review of the current literature is warranted.

Veterinary Data Synthesis

Investigation of hIVIG therapy in veterinary patients has been limited to the subjects of immune-mediated hemolytic anemia (IMHA), immune-mediated thrombocytopenia (ITP), Evan's syndrome, cutaneous disease, myasthenia gravis (MG), and sudden acquired retinal degeneration (SARDS). Proponents of veterinary hIVIG use believe administration may reduce transfusion requirements and decrease hospitalization time.

Conclusion

Immunoglobulin (Ig) has not been shown to decrease transfusion requirements in IMHA patients, but shows great promise for treatment of ITP and dermatological diseases. Although serial transfusion of hIVIG is employed in human medicine, repeated transfusion is not recommended in animals due to risk of severe allergic reaction. Other potential adverse effects of transfusion include delayed hypersensitivity reactions, thromboembolism, renal failure, hypotension, and aseptic meningitis.

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