Intravenous immunoglobulin (IvIg) infusions take 3-4 hours, if the instructions of the producer are followed, and the patients and parents have to spend considerable time at the hospital. The tolerance of IvIg infusions given at a rate that would allow an infusion of 0.5 g/kg to be completed within 1-1.5 hours have been investigated in an open, prospective, randomized study.

Method: 22 patients, 15 children and 7 adults, with primary or secondary immunodeficiencies participated. After one uneventful infusion of 0.5 g/kg IvIg (Gammonativ®) each patient was given 4 infusions at«normal» infusion rate (4 ml/kg per hour for children) and 4 at an increased rate (maximum 10 ml/kg per hour).

Results: 21 patients fulfilled the study, 1 patient refused any IvIg substitution after 2 infusions. Together 85 infusions with «normal» infusion rate and 85 infusions with increased rate were given. 12 patients tolerated all their infusions without any adverse events, while 10 experienced adverse events. Of these 10 patients, 4 had adverse events at both infusion rates, 5 at the increased infusion rate, and I only at normal rate. This difference is not statistically significant.

The adverse events were mild and included chills, fever, slight to moderate headache, and lumbar pain. No infusion was stopped because of adverse events, but 11 infusions were interrupted temporarily.

Conclusions: IvIg might very well be given at the increased infusion rate and is usually tolerated without adverse events. Individualizing the therapy is important as adverse events, although mild, are common both at the «normal» infusion rate and at increased rate.