What is IVIG?
IVIG is derived from human plasma wherein blood products are removed, and the purified product treated to inactivate hepatitis C and other viruses. All donors are tested for hepatitis and HIV as required by the Federal Drug Administration. These tests are required by laws intending to eliminate risk of transmitting viruses causing hepatitis and/or acquired immunodeficiency syndrome (AIDS). Creutzfeldt-Jacob Disease (CJD) is a rare transmissible degenerative disease of the nervous system. There have been no documented cases of acquiring CJD from receiving blood or blood plasma products. In addition, the risk for developing infection from hepatitis and human immunodeficiency virus (HIV) is virtually negligible.
When is IVIG used?
IVIG is indicated in a variety of acquired peripheral neuropathies, rare neuromuscular transmission disorders, Stiff-person’s syndrome, and some inflammatory myopathies.
How is IVIG given?
An IV is started most likely in your arm or hand. The amount of IVIG given is based on your weight and the IV treatment may take several hours depending on the dosage. One treatment may take up to 5 hours to infuse. Some patients receive treatments on consecutive days; others will have treatments spread over a several week period. This depends on your particular physician.
Where is IVIG given
The Neuromuscular Center provides IVIG on an outpatient basis.
Treatment of Neuromuscular Disorders
The Neuromuscular Center utilizes a multi-disciplinary approach to optimize treatment of neuromuscular disorders. This includes the use of appropriate medications, and:
- Intravenous Immunoglobulin (IVIG)
- Therapeutic Apheresis
- Ancillary Services – Physical and occupational therapy, speech therapy, and pain management.
What are the possible side effects of IVIG treatments?
Although generally safe, as with all treatments, patients undergoing IVIG treatment may experience adverse reactions. The most common is an allergic reaction manifested by minor headache, nausea, diarrhea, flushing, fever, chills, and backache. Rare complications include a rise or lowering of blood pressure, chest tightness, shortness of breath, kidney failure, hyperviscosity states, and aseptic meningitis. In order to provide this treatment in the safest manner possible, the first infusion of IVIG is always given in a hospital or office clinic setting in the presence of a trained nurse and available medical personal.
If you have any questions concerning IVIG, please call Monica Posedly, RN, BSN at 216.444.5077.
What is Therapeutic Apheresis?
Therapeutic apheresis or plasma exchange is a method for removing toxic elements from the blood. The procedure involves removing blood, separating the plasma from the formed elements, and re-infusing the formed elements together with a plasma replacement.
When is Therapeutic Apheresis used?
Indications for therapeutic apheresis include a variety of acquired peripheral neuropathies, myasthenia gravis, and the Lambert-Eaton myasthenic syndrome.
How is Therapeutic Apheresis given?
Most patients undergoing apheresis require central venous access. This entails placing a catheter in the large venous vessels about the base of the neck. In patients with adequate peripheral veins, an intravenous line can be placed in the arm. As with any procedure, there is a risk of bleeding and infection. However, the venous lines placed for apheresis are temporary and are removed as soon as the treatments are complete (usually over 7–10 days).
Where is Therapeutic Apheresis given?
The Neuromuscular Center at the Cleveland Clinic coordinates this treatment with the Therapeutic Apheresis Unit, located in Building M12. The Therapeutic Apheresis Unit has over 40 years of experience and is dedicated to performing plasma exchange and other apheresis treatments. The unit, under the direction of Dr. Anna Koo, MD, is staffed by 4 full-time registered nurses.
What are the possible side effects of Therapeutic Apheresis?
Since the process of apheresis involves removing portions of whole blood, there may be problems with fluid balance and changes in blood pressure. Overall, the treatment is tolerated well. Most side effects relate to the placement of venous access; this involves localized bleeding and infection. Rare complications of the treatment include disorders of the coagulation pathways, allergic reactions, blood clots, and sepsis.
If you have any questions concerning Therapeutic Apheresis, please ask your physician or call the Therapeutic Apheresis Unit at 216.444.2633, or call toll free 800.CCF.CARE ext. 42633.