Intravenous Immunoglobulin uses

Question 1

IVIG can be used as post-exposure prophylaxis or treatment

What infective conditions is it used as treatment?

Answer 1

Infection:
- viral pneumonitis - CMV pneumonitis post-transplant - give with ganciclovir
- Red cell aplasia due to Parvo B19

• PVL Staph
• Staph toxic shock syndrome
• C.difficile - recurrent or severe

Non-infectious
- HLH
- Kawasaki
- ITP
- GBS/ CIDP
- TEN/ SJS

Question 2

Solid organ transplant IVIG is also indicated for viral pneumonitis.

What infections is IVIG indicated for?

Answer 2

Viral pneumonitis in solid organ transplant - usually cardiothoracic

• HSV
• VZV
• CMV
• RSV

excluding influenza/ covid

IVIG 0.5g/kg for 5 days

Question 3

What types of immunoglobulin is available?

Answer 3

HNIG

Diseases specific IVIG - e.g HBIG/ VZIG

Question 4

IVIG can be used as post-exposure prophylaxis or treatment

What are uses for HNIG as post-exposure prophylaxis?

Answer 4

Hepatitis A contacts

Measles contacts

Rubella Contacts

Polio - some evidence

Enterovirus outbreaks - some evidence

Children with HIV - not routinely used

Question 5

IVIG can be used as post-exposure prophylaxis or treatment

What are uses for disease specific IVIG as post-exposure prophylaxis?

Answer 5

HBIG

VZIG

RIG

Tetanus immunoglobulin

Diphtheria antitoxin

Botulism antitoxin