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To the Editor—We have previously reported an association between IgG2 deficiency and severe H1N1 infection [1]. We now describe 5 such patients who were failing antiviral therapy and were treated with intravenous immunoglobulin (IVIG) as potential salvage therapy. The patient clinical characteristics, laboratory features, treatment, tolerability, and overall outcomes are described in Table 1. All patients had known risk factors for severe H1N1 infection (pregnancy, n 5 2; asthma, n 5 1; obesity and asthma, n 5 1; chronic lymphocytic leukemia plus high-dose corticosteroids, n 5 1). All patients required mechanical ventilation (mean, 19 days; range, 5–38 days) and 3 required extracorporeal membrane oxygenation (ECMO; mean, 13 days; range, 9–17 days). IVIG was administered after mean illness duration

clinical infectious diseases/clinical infectious diseases (online. university of chicago. press)

Pooled Human Immunoglobulin Therapy in Critically Ill Patients With Pandemic 2009 Influenza A(H1N1) Pneumonitis and Immunoglobulin G2 Subclass (IgG2) Deficiency