Predictive factors of first dosage intravenous immunoglobulin-related adverse effects in children


Autoři: Jun Kubota aff001;  Shin-ichiro Hamano aff001;  Atsuro Daida aff001;  Erika Hiwatari aff001;  Satoru Ikemoto aff003;  Yuko Hirata aff001;  Ryuki Matsuura aff001;  Daishi Hirano aff002
Působiště autorů: Division of Neurology, Saitama Children's Medical Center, Saitama, Japan aff001;  Department of Pediatrics, The Jikei University School of Medicine, Tokyo, Japan aff002;  Department for Child Health and Human Development, Saitama Children's Medical Center, Saitama, Japan aff003
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227796

Souhrn

Background

Intravenous immunoglobulin (IVIG) therapy is used in the treatment of various diseases, and IVIG-related adverse effects (IVIG-AEs) vary from mild to severe. However, the mechanisms underlying IVIG-AEs and the potential predictive factors are not clear. This study investigated whether certain IVIG-AEs can be predicted before IVIG administration.

Study design and methods

This retrospective cohort study at the Division of Neurology, Saitama Children’s Medical Center included patients enrolled from 2008 to 2018 who were < 18 years old and received IVIG for the first time. IVIG-AEs were classified according to the Common Terminology Criteria for Adverse Events version 5.0.

Results

A total of 104 patients fulfilled the inclusion criteria. The rate of IVIG-AEs was 37.5% (39/104). The most frequent IVIG-AEs were fever (41.0% [16/39]) and headache (38.5% [15/39]). AEs were below grade 2 in all except one patient and there were no grade 4 AEs. High serum total protein (TP) level was significantly related to the occurrence of IVIG-AEs (odds ratio, 14.8; 95% confidence interval, 2.4–90.5; P < 0.01). The optimal cutoff TP level was 6.7 g/dL. Although low WBC count and immunoglobulin G level may be predictive risk factors of IVIG-AEs, it was not confirmed in this study.

Conclusion

IVIG-AEs occurred in 37.5% of cases, and most were mild. TP was the best predictive risk factor of IVIG-AEs before IVIG administration. These results may aid in elucidating the mechanism underlying IVIG-AEs.

Klíčová slova:

Abdominal pain – Adverse events – Antibodies – Blood – Epilepsy – Headaches – Medical risk factors – Pediatrics


Zdroje

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