Immunoglobulin therapy is the administration of human polyvalent IgG and represents the most effective treatment to prevent recurrent infections in antibody deficiency patients. Primary antibody deficiency represents the main indication of immunoglobulin replacement therapy and includes a wide range of disorders characterized by impaired antibody production in response to pathogens and recurrent infections. However, not all primary antibody deficiency patients require immunoglobulin replacement. Indeed, immunoglobulin preparations are expensive and, once prescribed, usually result in lifelong therapy. Moreover, many patients significantly benefit from a long-term antibiotic prophylaxis and a prompt begin of antibiotic therapy in case of infectious events. Even more controversial is the decision to initiate immunoglobulin replacement therapy in secondary antibody deficiency, a heterogeneous and expanding group including B-cell lymphoproliferative syndromes, protein losing states and therapeutic agents. This review seeks to define the indication to immunoglobulin replacement in primary and secondary antibody deficiency disorders, distinguishing those in which the beginning of immunoglobulin therapy is always indicated at the same time as the diagnosis has been made, from those lacking of defined indication to replacement therapy. In addition, we propose a clinical approach, mainly based on the evaluation of infectious history, vaccine response and bronchiectasis finding, to support the decision to initiate immunoglobulin therapy in an individual patient.

Immunoglobulin replacement therapy in primary and secondary antibody deficiency: The correct clinical approach / Pecoraro, Antonio; Crescenzi, Ludovica; Granata, Francescopaolo; Genovese, Arturo; Spadaro, Giuseppe. - In: INTERNATIONAL IMMUNOPHARMACOLOGY. - ISSN 1567-5769. - 52:(2017), pp. 136-142. [10.1016/j.intimp.2017.09.005]

Immunoglobulin replacement therapy in primary and secondary antibody deficiency: The correct clinical approach

Pecoraro, Antonio;Crescenzi, Ludovica;Granata, Francescopaolo;Genovese, Arturo;Spadaro, Giuseppe
2017

Abstract

Immunoglobulin therapy is the administration of human polyvalent IgG and represents the most effective treatment to prevent recurrent infections in antibody deficiency patients. Primary antibody deficiency represents the main indication of immunoglobulin replacement therapy and includes a wide range of disorders characterized by impaired antibody production in response to pathogens and recurrent infections. However, not all primary antibody deficiency patients require immunoglobulin replacement. Indeed, immunoglobulin preparations are expensive and, once prescribed, usually result in lifelong therapy. Moreover, many patients significantly benefit from a long-term antibiotic prophylaxis and a prompt begin of antibiotic therapy in case of infectious events. Even more controversial is the decision to initiate immunoglobulin replacement therapy in secondary antibody deficiency, a heterogeneous and expanding group including B-cell lymphoproliferative syndromes, protein losing states and therapeutic agents. This review seeks to define the indication to immunoglobulin replacement in primary and secondary antibody deficiency disorders, distinguishing those in which the beginning of immunoglobulin therapy is always indicated at the same time as the diagnosis has been made, from those lacking of defined indication to replacement therapy. In addition, we propose a clinical approach, mainly based on the evaluation of infectious history, vaccine response and bronchiectasis finding, to support the decision to initiate immunoglobulin therapy in an individual patient.
2017
Immunoglobulin replacement therapy in primary and secondary antibody deficiency: The correct clinical approach / Pecoraro, Antonio; Crescenzi, Ludovica; Granata, Francescopaolo; Genovese, Arturo; Spadaro, Giuseppe. - In: INTERNATIONAL IMMUNOPHARMACOLOGY. - ISSN 1567-5769. - 52:(2017), pp. 136-142. [10.1016/j.intimp.2017.09.005]
File in questo prodotto:
File Dimensione Formato  
74. Int Immunopharmacol 2017.pdf

solo utenti autorizzati

Tipologia: Documento in Post-print
Licenza: Dominio pubblico
Dimensione 384.18 kB
Formato Adobe PDF
384.18 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/712454
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 25
  • ???jsp.display-item.citation.isi??? 17
social impact