Name of the Procedure:

• Common Name(s): Injection, immune globulin (Gammagard Liquid)
• Technical/Medical Term: Intravenous immunoglobulin (IVIG) therapy, non-lyophilized, 500 mg (HCPCS Code: J1569)

Summary

This procedure involves the intravenous injection of immune globulin (Gammagard Liquid). Immune globulin is a blood product used to boost the immune system in patients who are unable to produce enough antibodies on their own.

Purpose

• Medical Conditions or Problems Addressed: Primary and secondary immune deficiencies, certain autoimmune diseases, and some acute infections.
• Goals or Expected Outcomes: Strengthening the immune system, reducing the risk of infections, and managing autoimmune conditions.

Indications

• Specific Symptoms or Conditions: Recurrent infections, chronic inflammatory demyelinating polyneuropathy (CIDP), primary immune deficiency diseases, Guillain-Barre Syndrome, and other autoimmune diseases.
• Patient Criteria: Patients with diagnosed immune deficiencies, autoimmune disorders, or those requiring passive immunity due to acute infection.

Preparation

• Pre-procedure Instructions:
  • Hydration: Patients are encouraged to drink plenty of fluids before the procedure.
  • Medications: Some patients may need to adjust current medications; consultation with a doctor is necessary.
• Diagnostic Tests or Assessments: Blood tests to determine immune function, assessment of medical history, and physical examination.

Procedure Description

• Step-by-Step Explanation:
  1. Preparation: The patient is seated or lying comfortably. An IV line is established.
  2. Injection: Gammagard Liquid is slowly infused through the IV over several hours.
  3. Monitoring: Continuous monitoring for any adverse reactions throughout the infusion.
• Tools, Equipment, or Technology Used: IV catheters, infusion pumps, monitoring equipment.
• Anesthesia or Sedation: Not typically required; local numbing cream may be used for IV insertion site.

Duration

• Typically takes 2 to 4 hours, depending on the dosage and patient response.

Setting

• Usually performed in an outpatient clinic, hospital, or specialized infusion center.

Personnel

• Infusion nurse, supervising physician (allergist or immunologist), and possibly a pharmacist.

Risks and Complications

• Common Risks: Mild headache, nausea, local site reactions, fever.
• Rare Risks: Severe allergic reactions (anaphylaxis), kidney problems, blood clots, aseptic meningitis.
• Management of Complications: Immediate medical intervention for severe allergic reactions, supportive treatments for minor side effects.

Benefits

• Expected Benefits: Reduction in infections, stabilization of immune function, improvement of autoimmune symptoms.
• Realization Time: Benefits often seen within days to weeks after treatment.

Recovery

• Post-procedure Care: Monitoring for a short period after the infusion for any delayed reactions.
• Expected Recovery Time: Most patients resume normal activities within hours. Some may need a day of rest.
• Follow-up Appointments: Regular follow-ups for patients requiring ongoing therapy.

Alternatives

• Other Treatment Options: Antibiotics for infections, corticosteroids for inflammation, plasmapheresis for certain autoimmune conditions.
• Pros and Cons:
  • IVIG: Effective but expensive; requires regular infusions.
  • Alternatives: May have different side effects or be less effective for certain conditions.

Patient Experience

• During the Procedure: May feel mild discomfort at the IV site; possible mild side effects like headache or chills.
• After the Procedure: Most patients feel fine; some may experience fatigue or mild flu-like symptoms.
• Pain Management and Comfort Measures: Over-the-counter pain relievers can manage post-infusion discomfort; hydration and rest are encouraged.