Abstract
Commonly used replacement therapies for patients with hyponammaglobulinemia are intramuscular gamma globulin (IM-GG) and plasma. Disadvantages of the former include discomfort of the injections and occasional reactions and, of the latter, the risk of henatitis. Intravenous gamma globulin altered enzymatically by plasmin(PT-GG) offers an alternative mode of treatment. In this study 175 infusions of PT-GG were administered to 14 patients with various forms of hypogammaglobulinemia. Our product had essentially no anticomplementary activity (1.1-1.4 CH50 units fixed/mg protein) with minimal fragmentation of the IgG molecule (<15%). Nine of the patients were studied in 2 treatment periods of 6 and 9 months with an intervening control period of 5 months on IM-GG. Frequency of infusion ranged from 2-4 weeks to maintain a serum IgG concentration of >2.5 mg/ml. Patient acceptance was uniformly positive. Eight of 11 patients maintained on IM-GG before entering the study had chronic pulmonary disease; 3 were removed from the study and placed on single donor plasma because of lack of improvement. The remaining patients had a significant decrease in number of hospitalizations and severe infections; 7 had diminution in sinusitis and otitis media. Five patients had one or more reactions (14/175 infusions). Symptoms abated rapidly with temporary interruption of the infusion. From these results we conclude that PT-GG represents a relatively safe, efficacious mode of replacement therapy in patients with hypogammaglobulinemia.
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Magilavy, D., Cassidy, J., Tubergen, D. et al. EFFICACY OF PLASMIN-MODIFIED INTRAVENOUS GAMMA GLOBULIN IN THE MANAGEMENT OF HYPOGAMMAGLOBULINEMIA. Pediatr Res 11, 490 (1977). https://doi.org/10.1203/00006450-197704000-00720
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DOI: https://doi.org/10.1203/00006450-197704000-00720