Impact of IVIG therapy on serologic testing for infectious diseases

Diagn Microbiol Infect Dis. 2020 Feb;96(2):114952. doi: 10.1016/j.diagmicrobio.2019.114952. Epub 2019 Nov 23.

Abstract

Intravenous immunoglobulin (IVIG) is used to treat an increasing number of conditions. The anti-inflammatory and immunomodulatory effects of IVIG can be life-saving; however, recent administration may complicate evaluation for infection. To assess the impact of IVIG therapy on a variety of common viral, bacterial, fungal, and parasitic serologies we prospectively evaluated serologic changes pre- and post-IVIG infusion in 7 participants. The number of new antibody detections ranging from 2 to 5. New detections included positivity for Epstein-Barr virus early D antigen, herpes simplex virus, West Nile virus, cytomegalovirus, and the endemic mycoses Histoplasma and Coccidioides. The greatest number of newly positive serologies was observed in subjects receiving cumulative doses of IVIG in excess of 100 g. Our results illustrate the difficulty in serologic interpretation following IVIG therapy and suggest a dose-response to new positive results. These findings may be a helpful resource to clinicians facing similar circumstances.

Keywords: IVIG; Infection; Serology.

MeSH terms

  • Adult
  • Aged
  • Antibodies, Viral / isolation & purification
  • Communicable Diseases / diagnosis*
  • Communicable Diseases / drug therapy*
  • Communicable Diseases / immunology
  • Female
  • Humans
  • Immunoglobulin G / therapeutic use
  • Immunoglobulins, Intravenous / therapeutic use*
  • Male
  • Middle Aged
  • Serologic Tests*
  • Treatment Outcome

Substances

  • Antibodies, Viral
  • Immunoglobulin G
  • Immunoglobulins, Intravenous