Infusion of intravenous immune globulin (IVIG) may be followed by an acute infusion reaction.


Clinical features of the acute infusion reaction:

(1) headache

(2) fever

(3) chills

(4) myalgia

(5) nausea and vomiting

(6) hypotension

(7) backache

(8) flushing


The onset is usually within 1 hour of starting the infusion.


Symptoms using resolve within 30 minutes. The infusion often can be continued at a slower rate of infusion.


Risk factors:

(1) rapid infusion

(2) infusion of a large dose

(3) failure to respond to symptoms (reduce infusion rate or discontinue until symptoms subside)


Need to consider other acute reactions to IVIG:

(1) hemolysis

(2) renal failure

(3) aseptic meningitis

(4) acute lung injury

(5) anaphylaxis


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