Autoimmune diseases


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What is IVIG or Intravenous Immune Globulin?

IVIg is a collection of Y shaped antibodies called IgG . Same antibodies as present in mothers milk.

IVIg is a plasma product formed by taking antibodies from about 20,000 donors and mixing them together. IVIg has proven effective in several immune system disorders, including nearly all autoimmune conditions like CIDP GBS
The sooner you treat the patient with IVIg the better the results. The window of opportunity usually within the first 18 months during which IVIg administration is ideal. The longer you wait the longer it will take for IVIg to work.

After being exposed to toxins and poisonous chemicals including carbon monoxide the body's immune system may mount a attack on the body. This autoimmune attack can be reversed by IVIG.

2.How Does IVIg work?

For immune deficiency where the body does not make enough antibodies, IVIG supplies them. For autoimmune disorders like GBS & CIDP, there is a abnormal autoantibody being formed which is inactivated by IVIG.Once IgG antibodies inactivate the attacking cells then body cells start to repair themselves healing takes place.

Patients with autoimmune disorders like CIDP also are deficient in antiidotype antibodies. IVIG has antiidotype antibodies & improve the patients condition. IVIg has a higher concentration of antiidotype antibodies.

3. Timeto have a effect?

After IVIg infusion, patients may see a response in their disease within 24- 48 hours. Some patients will have to wait 3-4 weeks to see an effect after IVIg. In a few no effect may be seen following IVIg infusion. If 4-5 cycles of IVIg do not show any response then increase the dose of IVIg and later also change the brand if no response is seen . The NIH recommends that if no response is seen with IVIg infusions, then add steroids to the treatment plan.

Everyone is slightly different as it depends on how long has the disease process been going on.

4. Why is IVIG so expensive?

IVIg is obtained from plasma, donors are paid then the plasma is sent to a processing centers for mixing, antibody removal, chemical treatment and filtration to remove viruses. This is followed by the products to be freeze dried. All this ends up for IVIG to be priced at $ 48 to $ 68 a gram. A single IVIg infusion costs about $3000 for a child and 10,000 for an adult. For a child the cost of IVIg is low because only a few grams are used. The price of IVIg in India is $25 a gram. In Pakistan IVIg costs 20 a gram. IVIg can be bought from China at 45-10 A Gram. Lowest price is in Bangladesh Baygam from Germany for $10 a gram. This low price is due to expired bottles brought form Saudia Arabia

5.How is IVIG administered?

IVIG is mixed in a bag and a tube runs from it to a vein usually in the arm. The recommended way to infuse IVIg includes a pump. Usually IVIg is given at a rate of 100 cc/ hour to 200 cc/ hour.

The rate is of IVIg is reduced for any problems such as headaches, rash, fatigue, hypertension or hypotension. For an adult's infusion of IVIg is usually given over 5 to 6 hours.

6. What are the common side effects OF IVIG?

Young petiet women  will experience headaches and Fatigue similar to getting a Flu, which is due to antibodies interaction. Rash is seen after IVIg and it is recommended they take Benadryl or even steroids to avoid this. There are a lot of antibodies in IVIg and some may result in odd reactions. After IVIg if odd symptoms are seen then use of steroids usually helps. Blood pressure changes are also seen.

7. How can one reduce the side effects of IVIG?

If you have any severe side effect like headache switch to subcutaneous, if you are high risk of stroke or heart attack or you get chest pains switch to subcutaneous IgG. Remember to drink 7 glasses of water or juice a day for hydration before starting the IVIG treatment and continuing this a month after the last IVIg infusion. Remember to take a baby aspirin to prevent thrombophelebitis after IVIg. Check with their doctors if they can use asprin and should not take this if they are on coumadine or have bleeding disorders. Do not use asprin if you have stomach ulcers. Low dose prednisone will reduce side effects like headaches. Best way for women to reduce headaches is to get IgG subcutaneously.

8 Where is the IVIG treatment given? IVIg Best place is home . Some patients have even taken this at work. Others in Hospital due to copay issues.AtAt home you can rest after IVIG, no one wants to be stuck in traffic and feeling weak after the IVIG . Thus best place is home unless you have co-pay issues. Covid  and monkey pox another reason too stay at home. You can also ask for remote monitoring of your heart rate and blood preassure at home. That way you are monitored 24 hours a day by the infusion company.

9. What is the frequency of the IVIG treatment given?Usually a dose of IVIg is 2 grams per kilogram is divided into five doses and 400mg/kg is infused daily for 5 days. (For the first time only) Some patient can tolerate consecutive days of IVIg. It is recommended that young women take this on alternate days.

For CIDPUSA Foundation

IVIG is used in neurology .IVIG is used for alzheimers. IVIg is used for asthma. IVIg is used for pemphigus. IVIg is used to treat vasculitis. IVIg is used in arthritis. IVIg is used for polyneuropathy. IVIg is used to treat renal disease. IVIg is used for gastrointestinal problems. IVIg can be used for almost 101 diseases. In immune deficiency IVIG is used to make the immune system stronger. So IVIg is used in cancer, IVIg can treat thrombocytopenia. IVIg is used in Kawasaki disease and low platelet count will increase the platelet count with Rx.

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