Intravenous Immunoglobulin Treatment

Intravenous immunoglobulin (IVIg) has been found in several clinical trials to benefit severe chronic steroid-dependent asthma. IVIg is approved by the FDA for treatment of primary immunodeficiency; however, it is not approved for the treatment of asthma at this time. Reports have also shown the benefit of IVIg for allergic and chronic respiratory diseases such as chronic sinusitis, atopic dermatitis, urticaria and asthma. Treatment with IVIg has been studied in a small group of children with chronic sinus disease who did not suffer from an underlying immunodeficiency. Such individuals received monthly infusions of IVIg. Treated individuals demonstrated a significant decrease in the number of antibiotic courses needed for sinusitis over 1 year. These findings suggest that IVIg may be an additional medical treatment for those with severe relapsing chronic sinus disease. Treatments with IVIg may work by supplementing the body’s immune system in fighting persistent infections. However similar to asthma IVIg has not been approved by the FDA as a standard treatment for allergies or sinus disease. This is an extremely expensive and time consuming form of therapy. Treatments consist of 4 - 8 hours of infusions once a month.

Risks and Precautions
IVIg is a sterile highly purified human immunoglobulin derived from large pools of human plasma. Rapid infusions can cause nausea, vomiting, back or abdominal pain, leg cramps, chest tightness, rapid heart rate, anxiety, itching, hives and flushing. Slowing down the infusion usually eliminates these symptoms. Rarely severe allergic reactions occur. If you have a history of heart disease, strokes, thrombosis, or blood clots, you should not receive this therapy. Aseptic meningitis syndrome has been infrequently reported to occur and is associated with severe headache, stiff neck, drowsiness, fever, nausea and vomiting. Kidney disease also has been reported as a complication.

This is one of the newer types of experimental treatments for severe steroid-dependent asthma. The exact mechanism of action is unknown. However, permanent side effects are rare, and IVIg therapy is considered by some specialists to be a reasonable alternative to continuing treatment with high dose, daily oral corticosteroids with their associated risks of significant side effects.