Intravenous immunoglobulin diarrhea

IMMUNODEFICIENCY WITH HYPER-IGM (HIGMl), AN IMMUNOGLOBULIN ISOTYPE SWITCH DEFECT CHARACTERIZED BY ELEVATED CONCENTRATIONS OF SERUM IGM AND DECREASED AMOUNTS OF ALL OTHER ISOTYPES. AFFECTED MALES PRESENT AT AN EARLY AGE (USUALLY WITHIN THE FIRST YEAR OF LIFE) RECURRENT BACTERIAL AND OPPORTUNISTIC INFECTIONS, INCLUDING PNEUMOCYSTIS CARINII PNEUMONIA AND INTRACTABLE DIARRHEA DUE TO CRYPTOSPORIDIUM INFECTION. DESPITE SUBSTITUTION TREATMENT WITH INTRAVENOUS IMMUNOGLOBULIN, THE OVERALL PROGNOSIS IS RATHER POOR, WITH A DEATH RATE OF ABOUT 10% BEFORE ADOLESCENCE. 

The most frequent adverse effects of intravenous immunoglobulin (Sandoz) for the treatment of various disorders (affecting 1-3% of patients in aU) were headache, nausea, vomiting, and fever. Some other mild sjmp-toms have an incidence below 1%, including abdominal pain, diarrhea, fatigue, malaise, dizziness, myalgia, and chest tightness. 

Gastrointestinal Nausea [39, 52 ], vomiting, and diarrhea have been associated with intravenous immunoglobulin [39 ]. 

The most commonly reported adverse events are mild local injection reactions, such as erythema, edema, swelling, pruritus, and local heat [48 , 60, 63 ], whose incidence decreases over time [48 ]. The incidence of non-infusion-site reactions after subcutaneous administration (0.24 events per infusion) is similar to the total incidence of 0.25 events per infusion during treatment with intravenous immunoglobulin [48 ]. Non-infusion-site adverse events after subcutaneous administration include headache, diarrhea, fatigue, and nausea [48 "]. 

Gastrointestinal Gastrointestinal adverse events include nausea, vomiting, anorexia, diarrhea, and cramping [I , SS , 54", 55 , 57 ]. Necrotizing enterocolitis after phototherapy and intravenous immunoglobulin for hemolytic disease of the newborn has been reported in three cases [64 ]. 

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