Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
CPT4 code
Name of the Procedure:
Common name(s): Subcutaneous Immune Globulin (SCIg) Infusion
Technical/medical terms: Immune globulin, human, for use in subcutaneous infusions, 100 mg, each
Summary
Subcutaneous Immune Globulin (SCIg) Infusion is a medical procedure where a protein product derived from human plasma is administered just under the skin to boost the immune system. This procedure can be managed at home or in a clinical setting and represents a more convenient alternative to intravenous therapy.
Purpose
Medical Condition or Problem:
SCIg is primarily used to treat disorders that affect the body's immune system, such as Primary or Secondary Immunodeficiency.
Goals or Expected Outcomes:
- Enhance immune system function
- Reduce frequency and severity of infections
- Improve overall quality of life for patients with immune deficiencies
Indications
- Patients with Primary Immunodeficiency (e.g., Common Variable Immune Deficiency, X-linked Agammaglobulinemia)
- Patients with Secondary Immunodeficiency (e.g., Chronic Lymphocytic Leukemia, Multiple Myeloma)
- Individuals who experience frequent, severe infections due to compromised immunity
Preparation
Pre-procedure Instructions:
- Usually, no fasting required
- Review current medications with a healthcare provider; some adjustments might be necessary
- Ensure no allergies to immune globulin or its components
Diagnostic Tests or Assessments:
- Blood tests to assess immune function
- Possibly skin tests to check for allergic reactions to immune globulin
Procedure Description
- Preparation: Wash hands thoroughly, clean the infusion site with antiseptic, and prepare the SCIg solution and infusion equipment.
- Site Selection: Choose and rotate infusion sites, typically thighs, abdomen, upper arms, or lower back.
- Administration:
- Insert a small needle under the skin at the chosen site.
- Connect the tubing to a syringe or a pump.
- Start the infusion at a controlled, slow rate as determined by your healthcare provider.
- Monitoring: Carefully monitor the site and the patient for any adverse reactions during the infusion.
Tools, Equipment, or Technology Used:
- Syringe or programmable infusion pump
- Infusion tubing and subcutaneous needles
- Antiseptics and sterile dressings
Anesthesia or Sedation:
- Usually, no anesthesia or sedation required
- Topical anesthetics may be applied to minimize discomfort
Duration
- The procedure typically takes 1 to 2 hours, depending on the dose and infusion rate.
Setting
- Can be performed in a hospital, outpatient clinic, or at home under medical supervision.
Personnel
- Healthcare professionals involved include: nurses, physicians, and pharmacists.
- When self-administered, patients should be adequately trained by healthcare providers.
Risks and Complications
Common Risks:
- Redness or swelling at the infusion site
- Mild headache or fatigue
Rare Risks:
- Allergic reactions (e.g., rash, itching)
- Anaphylaxis (severe allergic reaction)
- Infection at the infusion site
Management:
- Mild reactions can often be managed with over-the-counter medications.
- Medical intervention required for severe reactions.
Benefits
- Improved immune function and reduced infection rates
- Increased flexibility and convenience, particularly for self-administration at home
- Enhanced quality of life due to fewer infections and hospital visits
Recovery
Post-procedure Care:
- Keep the infusion site clean and monitor for signs of infection
- Hydrate well and rest if feeling fatigued
Expected Recovery Time:
- Minimal recovery time; most patients can resume normal activities shortly after the infusion
- Follow-up appointments to monitor immune levels and adjust treatment as needed
Alternatives
Other Treatment Options:
- Intravenous Immune Globulin (IVIg) therapy
- Prophylactic antibiotics
- Stem cell transplant (in severe cases)
Pros and Cons of Alternatives:
- IVIg: Requires clinic visits, potential for higher rates of systemic side effects.
- Prophylactic antibiotics: Only target specific infections, possible antibiotic resistance.
- Stem cell transplant: Potentially curative but carries significant risks and is suitable for a limited patient population.
Patient Experience
During the Procedure:
- Some discomfort or pain at the needle insertion site
- Possible stinging or burning sensation as the solution is infused
After the Procedure:
- Mild to moderate swelling or redness at the infusion site
- Fatigue or headache, which generally resolve with rest and hydration
Pain Management and Comfort Measures:
- Topical anesthetics for needle insertion
- Over-the-counter pain relievers for headache or mild discomfort
Overall, SCIg represents a practical and effective treatment option for patients with compromised immunity, offering flexibility and reduced complications compared to other methods.