IVIG Adverse Reactions: Potential Role of Cytokines and Vasoactive Substances

BACKGROUND AND OBJECTIVES: A clinical study was conducted to determine the effect of IVIG infusion rates on adverse experiences (AE) and on serum levels of cytokines and vasoactive substances. MATERIALS AND METHODS: Forty-two healthy volunteers were randomized into 3 groups with maximum IVIG infusion rates of 0.04, 0.06, and 0.08 ml/kg/min, and a final dose of 0.5 g IgG/kg body weight. RESULTS: Adverse reactions were noted only at the highest infusion rate of 0.08 ml/kg/min, except in 1 subject infused at 0.06 ml/kg/min. There were significant increases in IL-6 (p = 0.011) and thromboxane B2 (p = 0.007) in AE subjects as compared to non-AE subjects. CONCLUSION: IVIG-induced adverse reactions occur more often with rapid infusion rates and may be mediated by elevated levels of inflammatory cytokines and vasoactive substances.