| In vivo administration of intravenous immunoglobulin (IVIg) can lead to enhanced erythrocyte sequestration. | |
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MedLine Citation:
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PMID: 10441177 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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H Kessary-Shoham; Y Levy; Y Shoenfeld; M Lorber; H Gershon |
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Publication Detail:
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Type: In Vitro; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of autoimmunity Volume: 13 ISSN: 0896-8411 ISO Abbreviation: J. Autoimmun. Publication Date: 1999 Aug |
Date Detail:
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Created Date: 1999-11-04 Completed Date: 1999-11-04 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8812164 Medline TA: J Autoimmun Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 129-35 Citation Subset: IM |
Copyright Information:
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Copyright 1999 Academic Press. |
Affiliation:
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Department of Immunology, Rappaport Faculty of Medicine, Technicion, Haifa, Israel. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Antigen-Antibody Complex; 0/Hemoglobins; 0/Immunoglobulins, Intravenous; 0/Receptors, Complement 3b |
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