Immunoglobulin is a mixture of blood proteins called antibodies that are made by the immune system. Antibodies are formed when the immune system comes into contact with foreign substances that cause infections such as viruses or bacteria. These antibodies protect us from infection. Immunoglobulins can be extracted from donor blood and are used to treat a number of medical conditions. It is usually given to patients as an intravenous infusion when it is called intravenous immunoglobulin (IVIg).
IVIg is a blood product that combines immunoglobulins from many human blood donors.
IVIg comes from human plasma. Human plasma is the liquid part of the blood that does not contain red blood cells. Special processes are used in manufacturing IVIg to make it safe. These processes inactivate viruses that may be found in human plasma. There are several companies around the world that produce IVIg. There are slight differences in the way each company makes its product, but all IVIg products work the same way.
The body uses antibodies as a means of regulating immune responses. In some medical conditions, such as autoimmune conditions, the body’s immune system becomes overactive and starts attacking one or more body tissues such as; nerves, muscles or skin. IVIg is used as a treatment for these conditions by reducing and altering the immune systems response. In other conditions the immune system cannot make the antibodies needed to fight infectious diseases. IVIg replaces these antibodies so that the body can defend itself against infections and helps prevent longer-term organ damage. Detailed information on how IVIg is administered, including dose, side effects and risks can be found in the patient information leaflet (PIL) which accompanies every vial of IVIg. Please refer to the PIL or speak to your doctor or nurse directly if you have any further concerns.
IVIg is given by intravenous infusion (drip). You’ll need to go to the hospital
each time you have the treatment. The infusion will take several hours as the drug
has to be given slowly. The rate of the infusion will be increased during the first
hour if you have no problems. You’ll be observed closely and have your blood
pressure, pulse and temperature checked regularly. After the infusion has finished
you’ll need to be observed for an hour to check for any side-effects.
The dose of IVIg varies depending on which condition is being treated. It will also
be calculated according to your weight. Sometimes you’ll need to attend hospital
on just one day, sometimes on 2 consecutive days and sometimes on 5 consecutive
days. Some people may require repeat courses every 4 weeks.
People having IVIg may occasionally experience the following during or after the infusion:
- Chill
- Headache
- Stomach pain
- Fever
- Nausea (feeling sick)
- Vomiting
- Joint pain (particularly low back pain)
- Tiredness
In rare cases, people having IVIg may experience:
- Rash
- Abnormalities in liver function (detected by blood tests)
- Acute kidney failure
- Inflammation of the brain (aseptic meningitis)
- A type of anaemia called haemolytic anaemia, which will improve over time
All these rare side-effects can be treated. Very rarely, people may experience a severe allergic reaction to this drug treatment. The symptoms can include chest tightness, breathing difficulties, a rash, swelling of the face or tongue, and a drop in blood pressure. If this happens, urgent medical attention is needed. If the reaction is severe, then your treatment can’t be continued. Very occasionally, IVIg can cause a rise in blood pressure. A nurse will monitor you during the infusion but please report any new symptoms during or after the infusion. These reactions occur only in a minority of patients. The administration of IVIg can very rarely be associated with conditions caused by increased clotting of the blood – heart attack, stroke, and blood clots in the lung (pulmonary embolism) or legs (deep vein thrombosis, or DVT).
All donors of the blood from which IVIg is made are carefully screened for serious diseases that they may pass on to you. However, it’s impossible to completely eliminate the risk of passing on infection, for example with an unknown virus.
IVIg may interfere with the immune response following any vaccine and this can make the vaccine less effective. Therefore it’s best to avoid vaccines for at least 6 weeks (sometimes longer, depending on the exact vaccine) after having IVIg.
Some patients with a history of a severe allergic reaction to gammaglobulin or other blood products may not be able to receive further treatment with gammaglobulin, including Globucel®. If you have such a history, discuss this with your healthcare provider to determine if Globucel® can be safely administered to you.