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Anaphylactic Shock to Old, Dissolved Immunoglobulin

Am J Dis Child. 1988;142(10):1022-1023. doi:10.1001/archpedi.1988.02150100016009.
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Sir.—Therapeutic use of intravenous immunoglobulin has been recommended for the treatment of acute and chronic idiopathic thrombocytopenic purpura1 and neonatal sepsis.2,3 For prophylactic purposes, we infused 0.5 g of intravenous immunoglobulin (Sandoglobulin, Sandoz LTD, Basel, Switzerland) into healthy premature infants with birth weights of 1500 to 2000 g. Freshly dissolved immunoglobulin solutions were used, but for economic reasons the remainder of two bottles of immunoglobulin solutions was not discarded. These residues were stored at − 4°C to − 10°C for five and six days, respectively. The frozen solutions were rethawed and warmed to room temperature just before use. On infusion into two premature infants, we observed two anaphylactic reactions; one was lethal.

Patient Reports.—Patient 1.—A 1-day-old male infant (birth weight, 1700 g) was given 0.5 g of five-day-old immunoglobulin solution. It was infused slowly, at a rate of about seven to eight drops per minute.


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