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Intravenous immunoglobulin replacement prevents severe and lower respiratory tract infections, but not upper respiratory tract and non‐respiratory infections in common variable immune deficiency
Author(s) -
Favre O.,
Leimgruber A.,
Nicole A.,
Spertini F.
Publication year - 2005
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/j.1398-9995.2005.00756.x
Subject(s) - medicine , respiratory tract infections , respiratory system , respiratory tract , upper respiratory tract infection , respiratory disease , common variable immunodeficiency , antibody , lower respiratory tract infection , immune system , immunology , lung
Background: Although the dose of 400 mg/kg body weight intravenous immunoglobulins (IVIG) every 3–4 weeks is now standard for treating patients with common variable immune deficiency, studies demonstrating its long‐term benefits over low 200 mg/kg dose and its effects on infectious subsets (upper vs lower respiratory vs non‐respiratory infections) are rare. Methods: All patients from a single center with the diagnosis of common variable immune deficiency and whose clinical chart was available during three successive therapeutic periods [a pre‐IVIG replacement period, a low‐dose (200 mg/kg every 3 weeks) and a standard‐dose replacement period (400 mg/kg every 3 weeks)] were screened retrospectively. Results: Seven patients followed up for a total of 116 patient‐years over the three defined periods of observation were recruited. When compared with low‐dose therapy, standard‐dose intravenous immunoglobulin therapy raised trough IgG levels from 4.3 to 6.5 g/l and significantly decreased the overall frequency of infections, with marked effects on lower respiratory tract and severe infection number. In contrast, non‐respiratory and upper respiratory infections were, in comparison, resistant to therapy. Conclusions: Overall, these data support the use of standard‐dose 400 mg/kg intravenous immunoglobulin therapy, despite the high cost, to raise trough IgG levels to 5–7 g/l, but underlines that some categories of infectious events (non‐respiratory, upper respiratory) may need parallel surgical or pharmacological approaches to be optimally prevented or treated.