Status:
Ready to upload
Record number:
1764
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Uncommon but not rare
Time to detection:
Immediate to within first few days post infusion
Alerting signals, symptoms, evidence of occurrence:
Symptomatic hemolysis, dropping hct/hgb, +DAT with positive eluate
Demonstration of imputability or root cause:
+DAT with positive eluate with same specificity as observed in IVIG product
Imputability grade:
2 Probable
Groups audience:
Keywords:
References:
Suggest new keywords:
IVIG
hemolysis
Reference attachment:
Suggest references:
1) Hemolysis in patients with antibody deficiencies on immunoglobulin replacement treatment. Quinti I, et al. Transfusion. 2015 May;55(5):1067-74
2) https://www.ncbi.nlm.nih.gov/pubmed/22931280: IVIG--a hemolytic culprit. Pintova S, Bhardwaj AS, Aledort LM. N Engl J Med. 2012 Sep 6;367(10):974-6
3) https://www.ncbi.nlm.nih.gov/pubmed/19833910: Acute hemolysis after high-dose intravenous immunoglobulin therapy in highly HLA sensitized patients. Kahwaji J, et al. Clin J Am Soc Nephrol. 2009 Dec;4(12):1993-7
Note:
2 more references to be added (EP) - OK
Expert comments for publication:
It is well known that IVIG can cause hemolysis. This case series adds Rh specificity antibodies, in addition to the well described anti-A or anti-B isohemaglutinins. Other publications have speculated that anti-Rh specificity antibodies can cause hemolysis after IVIG and recommend monitoring hemoglobin 48-72 hours after infusion.