Adverse reactions associated with intravenous immunoglobulin therapy in patients with dermatologic diseases: An 11-year retrospective study

Background: Intravenous immunoglobulin (IVIG) is used to treat many autoimmune and immunodeficiency disorders. The main indications of IVIG in dermatology include treatment for resistant autoimmune bullous diseases, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). Although generally welltolerated, various adverse effects can occur. Methods: We designed a retrospective study to investigate the adverse effects of IVIG in all patients who received this drug in Razi Hospital from 2005-2016. Information was gathered from patients’ medical records. Results: During the study period, 67 patients received 94 IVIG infusions. The most common underlying dermatologic disease was pemphigus vulgaris (54 patients). The most frequent adverse effect of IVIG therapy was an increase in blood pressure for 17 patients and in 21 infusions of IVIG. Other adverse reactions included fatigue and generalized weakness, fever, chills, tachycardia, dizziness, a decrease in blood pressure, headache, flushing, chest discomfort, hemolysis, leukopenia, and deep vein thrombosis. Conclusions: Adverse events associated with IVIG therapy are usually mild and self-limiting. The incidence of serious adverse events is low. Identification of risk factors and close monitoring of high risk patients are essential to decrease the occurrence of serious adverse events.