The role of inflammation in intravenous immune globulin-mediated hemolysis.

Abstract:

:Intravenous immune globulin (IVIG) therapy has shown great success in a number of autoimmune and inflammatory conditions and its use continues to increase worldwide. There is growing awareness of significant side effects of high-dose IVIG: however, particularly severe hemolysis in patients that are non-group O. It has been proposed that IVIG-associated hemolysis may be heralded by an existing inflammatory condition. In the work presented herein, we have provided a review of the pathophysiology of inflammation, particularly as it applies in immune-mediated red blood cell hemolysis, and a summary of previous publications that suggest an association between IVIG-mediated hemolysis and a state of existing inflammation. In addition, preliminary results from a prospective study to address the mechanism of IVIG-associated hemolysis are provided. These preliminary data support the idea of an existing inflammatory condition preceding overt hemolysis after high-dose IVIG therapy that: 1) is restricted to non-group O patients, 2) is seen when using IVIG doses of more than 2 g/kg, 3) involves an activated mononuclear phagocyte system, 4) may be presaged by a significant increase in the anti-inflammatory cytokine interleukin-1 receptor agonist, and 5) is independent of secretor status.

journal_name

Transfusion

journal_title

Transfusion

authors

Pendergrast J,Willie-Ramharack K,Sampson L,Laroche V,Branch DR

doi

10.1111/trf.13097

subject

Has Abstract

pub_date

2015-07-01 00:00:00

pages

S65-73

eissn

0041-1132

issn

1537-2995

journal_volume

55 Suppl 2

pub_type

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