Initial intravenous immunoglobulin doses should be based on adjusted body weight in obese patients with primary immunodeficiency disorders.
Initial intravenous immunoglobulin doses should be based on adjusted body weight in obese patients with primary immunodeficiency disorders.
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DOI：
10.1186/s13223-017-0220-y
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Ameratunga R
中科院分区：
文献类型：
--
作者：
Ameratunga R
免疫球蛋白治疗在免疫缺陷疾病以及自身免疫和炎症性疾病的治疗中起着关键作用。在免疫缺陷患者中，静脉注射（IVIG）的初始负荷剂量是否应基于实际体重或计算参数（如肥胖患者的调整体重）一直存在争议。我描述了一个普通变异型免疫缺陷病（CVID）的病人，他因病态肥胖接受了减肥手术。她的体重下降了50%，低于计算的理想体重（IBW），而她的免疫球蛋白需求下降了约20%。她的稳态血清IgG从约7 g/l增加至11.7 g/l，同时体重减轻。我提出这一观察结果作为对免疫缺陷患者SCIG/IVIG初始负荷剂量应基于调整后体重（AjBW）而不是肥胖患者实际体重的建议的支持。这对治疗患有免疫缺陷疾病的肥胖患者具有重要的财政意义。
Immunoglobulin therapy plays a critical role in the treatment of immunodeficiency disorders as well as autoimmune and inflammatory conditions. In immunodeficient patients, there has been controversy whether initial loading doses of intravenous (IVIG) should be based on actual body weight or a calculated parameter such as adjusted body weight in obese patients. I describe a patient with Common Variable Immunodeficiency disorder (CVID) who underwent bariatric surgery for morbid obesity. Her weight decreased by 50% to below her calculated ideal body weight (IBW) while her immunoglobulin requirement fell by approximately 20%. Her steady state serum IgG increased from approximately 7 g/l to 11.7 g/l concomitant with weight loss. I present this observation as support for the recommendation that initial loading doses of SCIG/IVIG in immunodeficiency should be based on adjusted body weight (AjBW) and not actual body weight in obese patients. This has important fiscal implications for treating obese patients with immunodeficiency disorders.
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