|
Speciality |
Condition |
Prerequisites for consideration of IVIgG treatment |
Dosing schedule |
Monitoring |
|
Immunology |
Primary immunodeficiency |
Hypogammaglobulinaemia deficient total IgG or subclass deficiency |
0.2 g/kg 3−4 weekly |
Titre dose against levels and bacterial infections |
|
Haematology |
Idiopathic thrombocytopenic purpura + HIV-associated ITP |
Life-threatening haemorrhage or rapid increase in platelet count required or steroid contraindicated |
1 g/kg with second dose at 24 hours dependent on response |
Platelet count |
|
Allogeneic BMT for prevention of GvHD |
Allogeneic BMT |
0.5 g/kg day
weekly to d+90 |
|
|
NAITP |
Affected pregnancy with homozygous father or
fetal platelet count < 100 x 109/l |
1 g/kg/week from 20/40 weeks |
Fetal platelet count |
|
PTP |
Severely affected patient |
1 g/kg/day x 2 days |
Platelet count |
|
Secondary hypogam-
maglobulinaemia |
CLL/myeloma with low IgG levels and > 2 bacterial infections in 12-month period |
0.2 g/kg monthly |
Reduction in infections |
|
Neurology |
GBS + Miller Fisher syndrome |
Severe disease where TPE not immediately available |
0.4 g/kg/day x 5 days |
May be repeated if some measure of response |
|
CIDP + multifocal motorneuropathy |
Steroid treatment failed, not appropriate, or steroid side effects anticipated |
0.4 g/kg/day x 5 days, then 1 g/kg 4−6 weekly |
Stop once plateau achieved |
|
Myasthenia gravis + LEMS |
Acute exacerbations where TPE unavailable |
1 g/kg/day x 2 days |
|
|
Acute disseminated encephalomyelitis |
Failed high dose steroids |
1 g/kg/day x 2 days |
|
|
Rheumatology |
DM + PM |
Active recalcitrant disease which has failed immunosuppression |
1 g/kg/day x 2 days |
Repeated doses may be required |
|
SLE |
Only where thrombocytopenia is the major complication |
1 g/kg/day x 2 days |
Platelet count |
|
Kawasaki’s disease |
|
1−2 g/kg over 2−5 days |
|
|
Dermatology |
Pemphigus Vulgaris/
Bullous Pemphigoid |
Recalcitrant disease as an adjuvant to immunosuppressants |
1 g/kg x 2−5 days given monthly |
Stop once lesions healed |
|
Toxic epidermal necrolysis |
|
1−2 g/kg over 2−5 days |
|
|
Chronic urticaria |
Failed conventional therapy |
1−2 g/kg over 2−5 days |
Stop after 3 courses |
|
Infectious diseases |
Neonatal sepsis |
|
1−2 g/kg over 2−5 days |
|
|
Toxic shock/
necrotising fasciitis |
Adjuvant treatment to antibiotics and supportive care |
1 g/kg x 1 day, then 0.5 g/kg x 2 days |
|