Background: Intravenous immune globulin (IVIg) is a blood product prepared from the pooled plasma of thousands of donors. Originally, this therapeutic agent was used as a replacement therapy for patients with primary immunodeficiency, whereas today being extensively used in many immune-mediated conditions, mainly because of its known immunomodulatory effect.
Objective: In this study, we aim to assess the clinical indications and trends regarding the use of IVIg in a large tertiary pediatric medical center in Israel.
Methods: In a retrospective study, we manually reviewed medical records of pediatric patients who received at least one dose of IVIG from January 2008 until November 2017. We classified all subjects into groups according to medical indication and analyzed the data.
Results: A total of 705 patients (56% male) with a mean age of 6 (SD=5) were identified and included in this study. Immune-mediated conditions consisted 51% of patients treated with IVIg, whereas primary and secondary immunodeficient patients entitled 13% and 32%, respectively. Overall, more than 40 different indications for IVIg usage were observed in our study. The most common single indications were immune thrombocytopenic purpura (211 patients), bone marrow transplantation (205), Kawasaki disease (50) and Guillain Barre Syndrome (21). Interestingly, only 49% of patients received IVIg for registered ("labeled") indications thus many were treated with IVIg for off-labeled reasons.
Conclusions: Currently, IVIg is prescribed for a wide range of indications. The consumption of this therapeutic agent is annually growing as it is administered in approximately 50% of cases for off-label indications.
