Initial intravenous immunoglobulin doses should be based on adjusted body weight in obese patients with primary immunodeficiency disorders
Abstract Background Immunoglobulin therapy plays a critical role in the treatment of immunodeficiency disorders as well as autoimmune and inflammatory conditions. In immunodeficient patients, there has been controversy whether initial loading doses of intravenous (IVIG) should be based on actual bod...
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| Format: | Article |
| Language: | English |
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BMC
2017-12-01
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| Series: | Allergy, Asthma & Clinical Immunology |
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| Online Access: | http://link.springer.com/article/10.1186/s13223-017-0220-y |
| _version_ | 1819295182284128256 |
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| author | Rohan Ameratunga |
| author_facet | Rohan Ameratunga |
| author_sort | Rohan Ameratunga |
| collection | DOAJ |
| description | Abstract Background Immunoglobulin therapy plays a critical role in the treatment of immunodeficiency disorders as well as autoimmune and inflammatory conditions. In immunodeficient patients, there has been controversy whether initial loading doses of intravenous (IVIG) should be based on actual body weight or a calculated parameter such as adjusted body weight in obese patients. Case presentation I describe a patient with Common Variable Immunodeficiency disorder (CVID) who underwent bariatric surgery for morbid obesity. Her weight decreased by 50% to below her calculated ideal body weight (IBW) while her immunoglobulin requirement fell by approximately 20%. Her steady state serum IgG increased from approximately 7 g/l to 11.7 g/l concomitant with weight loss. Conclusions I present this observation as support for the recommendation that initial loading doses of SCIG/IVIG in immunodeficiency should be based on adjusted body weight (AjBW) and not actual body weight in obese patients. This has important fiscal implications for treating obese patients with immunodeficiency disorders. |
| first_indexed | 2024-12-24T04:38:09Z |
| format | Article |
| id | doaj.art-a93b9680d39e4e15bc620529a4858262 |
| institution | Directory Open Access Journal |
| issn | 1710-1492 |
| language | English |
| last_indexed | 2024-12-24T04:38:09Z |
| publishDate | 2017-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Allergy, Asthma & Clinical Immunology |
| spelling | doaj.art-a93b9680d39e4e15bc620529a48582622022-12-21T17:14:59ZengBMCAllergy, Asthma & Clinical Immunology1710-14922017-12-011311510.1186/s13223-017-0220-yInitial intravenous immunoglobulin doses should be based on adjusted body weight in obese patients with primary immunodeficiency disordersRohan Ameratunga0Department of Clinical Immunology, Auckland HospitalAbstract Background Immunoglobulin therapy plays a critical role in the treatment of immunodeficiency disorders as well as autoimmune and inflammatory conditions. In immunodeficient patients, there has been controversy whether initial loading doses of intravenous (IVIG) should be based on actual body weight or a calculated parameter such as adjusted body weight in obese patients. Case presentation I describe a patient with Common Variable Immunodeficiency disorder (CVID) who underwent bariatric surgery for morbid obesity. Her weight decreased by 50% to below her calculated ideal body weight (IBW) while her immunoglobulin requirement fell by approximately 20%. Her steady state serum IgG increased from approximately 7 g/l to 11.7 g/l concomitant with weight loss. Conclusions I present this observation as support for the recommendation that initial loading doses of SCIG/IVIG in immunodeficiency should be based on adjusted body weight (AjBW) and not actual body weight in obese patients. This has important fiscal implications for treating obese patients with immunodeficiency disorders.http://link.springer.com/article/10.1186/s13223-017-0220-yCVIDBariatric surgeryIVIGSCIG |
| spellingShingle | Rohan Ameratunga Initial intravenous immunoglobulin doses should be based on adjusted body weight in obese patients with primary immunodeficiency disorders Allergy, Asthma & Clinical Immunology CVID Bariatric surgery IVIG SCIG |
| title | Initial intravenous immunoglobulin doses should be based on adjusted body weight in obese patients with primary immunodeficiency disorders |
| title_full | Initial intravenous immunoglobulin doses should be based on adjusted body weight in obese patients with primary immunodeficiency disorders |
| title_fullStr | Initial intravenous immunoglobulin doses should be based on adjusted body weight in obese patients with primary immunodeficiency disorders |
| title_full_unstemmed | Initial intravenous immunoglobulin doses should be based on adjusted body weight in obese patients with primary immunodeficiency disorders |
| title_short | Initial intravenous immunoglobulin doses should be based on adjusted body weight in obese patients with primary immunodeficiency disorders |
| title_sort | initial intravenous immunoglobulin doses should be based on adjusted body weight in obese patients with primary immunodeficiency disorders |
| topic | CVID Bariatric surgery IVIG SCIG |
| url | http://link.springer.com/article/10.1186/s13223-017-0220-y |
| work_keys_str_mv | AT rohanameratunga initialintravenousimmunoglobulindosesshouldbebasedonadjustedbodyweightinobesepatientswithprimaryimmunodeficiencydisorders |