Clinical immunology
Polish experience with immunoglobulin replacement treatment by subcutaneous infusion

Immunoglobulin replacement therapy, regardless of the route of infusion, is the mainstay of treatment for patients affected by a variety of immunodeficiencies, particularly by primary antibody deficiency (PAD). Intravenous immunoglobulin therapy has been the most important and effective method of treatment. Unfortunately, in some patients it can cause life- threating adverse effects, while others present with poor vein access. That is why the subcutaneous immunoglobulin therapy is recommended for some patients. A comparison of clinical course, safety and efficacy of intravenous and post-registration subcutaneous immunoglobulin was carried out on a group of 15 patients aged between 3.8 yrs and 25 yrs with a diagnosis of primary antibody deficiency. The study showed that replacement therapy with subcutaneous gammaglobulin, given by patients or parents at home in a one week regimen is a safe and effective way to care for patients with PAD. The side effects are rare, being less frequent than in IVIG. The vast majority of patients experienced the local tissue reactions, which did not need any treatment and resolved themselves within less than one day. One child with a previous adverse event due to intravenous immunoglobulin presented with the mild to moderate side effects to SCIG. SCIG home therapy is an appreciated therapeutic alternative for adults and children with PAD.