Case Studies

Excerpt

A 24-year-old woman with common variable immunodeficiency (CVID) treated with intravenous immunoglobulin (IGIV) for 14 years. Current dose is 575 mg/kg monthly, and recent immunoglobulin levels were IgA, 41 mg/dL; IgG, 997 mg/dL; and IgM, 17 mg/dL. (565–1765 mg/dL for IgG, 85–385 mg/dL for IgA, and 55–375 mg/dL for IgM). Despite having dose levels that had been increased and trough levels that were adequate, she complains of malaise and fatigue and decreased intellectual function that begins 5 days before infusion and resolves 1 day after infusion. She has had 6 episodes of antibiotic-responsive purulent rhinorrhea in the past 12 months, most of which began during the week before her IGIV infusion. …