Immunoglobulin (gammaglobulin) replacement does not improve outcomes unless there is impairment of antigen-specific IgG antibody responses to vaccine immunizations or natural infections. Isolated decreases in immunoglobulins (isotypes or subclasses), alone, do not indicate a need for immunoglobulin replacement therapy. Exceptions include genetically defined/ suspected disorders. Measurement of IgG subclasses is not routinely useful in determining the need for immunoglobulin therapy. Selective IgA deficiency is not an indication for administration of immunoglobulin.

Conditions: Recurrent Infections, Impaired Antibody Responses to Vaccines

Treatments: Immunoglobulin Replacement Therapy (Gamma Globulin Replacement)

Sources

• Ballow, M. "Immunoglobulin Therapy: Replacement and Immunomodulation" in Clinical Immunology: Principles and Practice. 3rd edition. Rich RR, editor. St. Louis (MO): Mosby/Elsevier; 2008. 1265-80 pp. (ScienceDirect)
• Bonilla FA, Bernstein IL, Khan DA, et al. Practice parameter for the diagnosis and management of primary immunodeficiency. Ann Allergy Asthma Immunol. 2005 May;94(5 Suppl 1):S1-63. (PubMed)
• Orange JS, Hossny EM, Weiler CR, et al. Use of intravenous immunoglobulin in human disease: a review of evidence by members of the Primary Immunodeficiency Committee of the American Academy of Allergy, Asthma and Immunology. J Allergy Clin Immunol. 2006 Apr;117(4 Suppl):S525-53. (PubMed)
• Stiehm ER, Orange JS, Ballow M, et al. Therapeutic use of immunoglobulins. Adv Pediatr. 2010;57(1):185-218. (PubMed)