Document Detail


In vivo administration of intravenous immunoglobulin (IVIg) can lead to enhanced erythrocyte sequestration.
MedLine Citation:
PMID:  10441177     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Enhanced erythrocyte sequestration is one of the very few major adverse effects of intravenous immunoglobulin (IVIg). IVIg contains high molecular weight IgG complexes ( approximately 300 kDa) which, in the presence of serum, mimic immune complexes by activating complement, binding to CR1 of red blood cells (RBC) (CD35) and mediating erythrophagocytosis. Four of seven patients undergoing IVIg therapy showed significant drops in haematocrit and haemoglobin that were not due to isoantibodies in the IVIg. Prior to treatment, patients' RBC carried IgG and complement (C') 3d that were not bound as immune complexes via CR1 (CD35). The patients whose RBC bound immune complex-like moieties and showed drops in haematocrit and haemoglobin subsequent to IVIg were young adults (22-35 years); older patients (50-69 years) showed no ill effects. In the presence of complement, RBC of young patients bound IVIg complexes in vitro while those of older patients did not. It is not the absolute levels of erythrocyte-associated IgG or C'3 fragments, neither pre- nor post-therapy, which are predictive of IVIg associated decreases in haematocrit and haemoglobin levels. Patient age and RBC inability to bind the IVIg immune complex-like moieties in vitro both appear to be predictors of resistance to sequestration after in vivo treatment with IVIg.
Authors:
H Kessary-Shoham; Y Levy; Y Shoenfeld; M Lorber; H Gershon
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Publication Detail:
Type:  In Vitro; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of autoimmunity     Volume:  13     ISSN:  0896-8411     ISO Abbreviation:  J. Autoimmun.     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-11-04     Completed Date:  1999-11-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8812164     Medline TA:  J Autoimmun     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  129-35     Citation Subset:  IM    
Copyright Information:
Copyright 1999 Academic Press.
Affiliation:
Department of Immunology, Rappaport Faculty of Medicine, Technicion, Haifa, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antigen-Antibody Complex / metabolism
Autoimmune Diseases / immunology,  therapy
Case-Control Studies
Complement Activation
Erythrocytes / immunology*
Female
Hematocrit
Hemoglobins / metabolism
Hemolysis
Humans
Immunoglobulins, Intravenous / adverse effects*,  chemistry
Male
Middle Aged
Molecular Weight
Phagocytosis
Receptors, Complement 3b / blood
Chemical
Reg. No./Substance:
0/Antigen-Antibody Complex; 0/Hemoglobins; 0/Immunoglobulins, Intravenous; 0/Receptors, Complement 3b

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