Is there any indication for IVIG in immunocompromised patients with only decreased IgM and/or IgA levels?
Answer from: at Community Practice
Nope. IVIG preparations contain IgG not IgA or IgM. Low serum IgA may or may not be associated with low IgA levels in mucosal surfaces leading to a risk of local infections. Low levels of one or both may be asymptomatic but in the right setting might suggest a need for evaluation of plasma cell dysc...
Comments
at UTMB Health Or associated autoimmune disease, especially with ...
I agree with Dr. @Sigal but would add the caveat that we should consider the patient's condition. If the patient is having signs/symptoms of increased infection, one should evaluate specific antibody levels and/or vaccine responses before dismissing the possibility that IgG replacement or augme...
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at Berkshire Health Systems Dr. @Berger raises a good point. Occasionally, nor...
The initial question is somewhat vague in reference to using the term "immunocompromised". That is a clinical, not a laboratory diagnosis. With few exceptions, low (as opposed to absent) levels of any Ig class are, in and of themselves, not diagnostic of a clinically relevant immune-compromised stat...
I agree with the above comments, but will add a cautionary comment. Whereas a low level of IgA is not an absolute contraindication to IVIG treatment, it does warrant caution. Some patients, more so with severe IgA deficiency and in particular those who also have anti-IgA antibodies, are at an increa...
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at Harvard Medical School Almost always choose SCIG unless the patient is re...
Very interesting convo @Melvin Berger. I inherited patients with this scenario, and was like hmm, I don't think these patients need immune globulin replacement therapy, but they came from providers who diagnosed them with IgG subclass deficiency. Also, probably had non-allergic rhinitis as opposed t...
Or associated autoimmune disease, especially with ...