Adverse reactions in a large cohort of patients with inborn errors of immunity receiving intravenous immunoglobulin

Hossein Esmaeilzadeh; Aida Askarisarvestani; Nazanin Hosseini; Sahar Samimi; Alireza Shafiei; Seyed Alireza Mahdaviani; Narges Eslami; Zahra Chavoshzadeh; Mazdak Fallahi; Nasrin Khakbazanfard; Mahnaz Sadeghi Shabestari; Soheila Aleyasin; Seyed Hesamedin Nabavizadeh; Taher Cheraghi; Arash Kalantari; Akefeh Ahmadiafshar; Mojgan Safari; Mohammad Hossein Eslamian; Rasol Molatefi; Afshin Shirkani; Marzieh Heidarzadeh Arani; Marzieh Tavakol; Mohammad Hassan Bemanian; Saba Arshi; Mohammad Nabavi; Sima Shokri; Babak Shahhosseini; Negar Mortazavi; Pooria Nakhaei; Farzad Nazari; Morteza Fallahpour; Hamid Ahanchian; Nasrin Moazzen; Maryam Khoshkhui; Ahmad Vosughi Motlagh; Asghar Aghamohammadi; Hassan Abolhassani; Reza Yazdani; Nima Rezaei

doi:10.1016/j.clim.2021.108826

Adverse reactions in a large cohort of patients with inborn errors of immunity receiving intravenous immunoglobulin

Clin Immunol. 2021 Sep:230:108826. doi: 10.1016/j.clim.2021.108826. Epub 2021 Aug 19.

Authors

Hossein Esmaeilzadeh¹, Aida Askarisarvestani², Nazanin Hosseini³, Sahar Samimi⁴, Alireza Shafiei⁵, Seyed Alireza Mahdaviani⁶, Narges Eslami⁷, Zahra Chavoshzadeh⁷, Mazdak Fallahi⁷, Nasrin Khakbazanfard⁷, Mahnaz Sadeghi Shabestari⁸, Soheila Aleyasin¹, Seyed Hesamedin Nabavizadeh¹, Taher Cheraghi⁹, Arash Kalantari¹⁰, Akefeh Ahmadiafshar¹¹, Mojgan Safari¹², Mohammad Hossein Eslamian¹², Rasol Molatefi¹³, Afshin Shirkani¹⁴, Marzieh Heidarzadeh Arani¹⁵, Marzieh Tavakol¹⁶, Mohammad Hassan Bemanian¹⁷, Saba Arshi¹⁷, Mohammad Nabavi¹⁷, Sima Shokri¹⁷, Babak Shahhosseini², Negar Mortazavi¹⁸, Pooria Nakhaei³, Farzad Nazari⁴, Morteza Fallahpour¹⁷, Hamid Ahanchian¹⁹, Nasrin Moazzen¹⁹, Maryam Khoshkhui¹⁹, Ahmad Vosughi Motlagh²⁰, Asghar Aghamohammadi⁴, Hassan Abolhassani²¹, Reza Yazdani⁴, Nima Rezaei²²

Affiliations

¹ Allergy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Division of Allergy and Clinical Immunology, Pediatrics Department, Shiraz University of Medical Sciences, Shiraz, Iran.
² Division of Allergy and Clinical Immunology, Pediatrics Department, Shiraz University of Medical Sciences, Shiraz, Iran.
³ Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
⁴ Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Primary Immunodeficiency Diseases Network (PIDNet), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
⁵ Division of Allergy and Clinical Immunology, Department of Pediatrics, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran.
⁶ Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁷ Allergy and Clinical immunology Dept, Mofid Children Hospital, , Shahid Beheshti University of Medical Sciences, Tehran, , Iran.
⁸ Department of Immunology and Allergy, Tabriz University of Medical Sciences, Tabriz, Iran.
⁹ Department of Pediatrics, 17th Shahrivar Children's Hospital, Guilan University of Medical Sciences, Rasht, Iran.
¹⁰ Department of Immunology and Allergy, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
¹¹ Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran.
¹² Department of Pediatrics, Hamadan University of Medical Sciences, Hamadan, Iran.
¹³ Department of Pediatrics, Bo-Ali children's Hospital of Ardabil University of Medical Sciences, Ardabil, Iran.
¹⁴ Allergy and Clinical Immunology Department, Bushehr University of Medical Science, School of Medicine, Bushehr, Iran.
¹⁵ Pediatric Department, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
¹⁶ Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
¹⁷ Department of Allergy and Clinical Immunology, Rasool e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
¹⁸ Department of Clinical Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
¹⁹ Allergy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
²⁰ Department of Pediatrics, North Khorasan University of Medical Sciences, Bojnurd. Iran.
²¹ Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Division of Clinical Immunology, Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden; Division of Clinical Immunology, Department of Laboratory Medicine, Karolinska Institute at Karolinska University Hospital Huddinge, Stockholm, Sweden; Primary Immunodeficiency Diseases Network (PIDNet), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
²² Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran; Primary Immunodeficiency Diseases Network (PIDNet), Universal Scientific Education and Research Network (USERN), Tehran, Iran. Electronic address: rezaei_nima@yahoo.com.

PMID: 34418548
DOI: 10.1016/j.clim.2021.108826

Abstract

Background: Intravenous immunoglobulins (IVIg) are the major treatment in inborn errors of immunity (IEI) disorders; However, IVIg infusions show some adverse effects. We aimed to assess the adverse reactions of IVIg infusions.

Methods: Data of IVIg infusions in IEI patients were collected from 2011 to 2021. Totally, 363 IEI patients received IVIg regularly in Iran entered the study. The adverse reactions are classified regarding their severity and chronicity.

Results: 22,667 IVIg infusions were performed in the study. 157 patients (43.2%) and 1349 (5.9%) infusions were associated with at least one type of adverse reaction. The highest rates of adverse reactions were seen in severe combined immunodeficiency. Myalgia, chills, headache, fever, and hypotension were the most frequent adverse effects of IVIg.

Conclusion: The reactions affect almost half of the patients mainly in the first infusions which necessitate the close observation of IEI patients receiving IVIg.

Keywords: Adverse reaction; Inborn errors of immunity; Intravenous immunoglobulins; Iran; Primary immunodeficiencies.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Agammaglobulinemia / genetics
Agammaglobulinemia / immunology
Agammaglobulinemia / therapy
Aged
Ataxia Telangiectasia / genetics
Ataxia Telangiectasia / immunology
Ataxia Telangiectasia / therapy
Child
Child, Preschool
Cohort Studies
Common Variable Immunodeficiency / genetics
Common Variable Immunodeficiency / immunology
Common Variable Immunodeficiency / therapy
Female
Humans
Immunoglobulins, Intravenous / administration & dosage
Immunoglobulins, Intravenous / adverse effects*
Immunologic Deficiency Syndromes / genetics*
Immunologic Deficiency Syndromes / immunology
Immunologic Deficiency Syndromes / therapy*
Infant
Infusions, Intravenous
Male
Middle Aged
Young Adult

Substances

Immunoglobulins, Intravenous