Name of the Procedure:

Injection, immune globulin/hyaluronidase, (Hyqvia), 100 mg immuneglobulin (HCPCS Code: J1575)

Summary

In this procedure, a combination of immune globulin and hyaluronidase is injected under the skin. The immune globulin helps boost the immune system, while hyaluronidase helps the immune globulin absorb more effectively. This procedure is commonly used to help patients with severe immune deficiencies by increasing their ability to fight infections.

Purpose

The main goal of this procedure is to provide patients with increased levels of antibodies to help them fight off infections more effectively. It is aimed at patients with certain types of primary immunodeficiency diseases or other conditions that affect the body's ability to produce adequate antibodies.

Indications

• Diagnosed with primary immunodeficiency diseases
• Low levels of functional antibodies
• Frequent or severe infections
• Conditions that require immune globulin replacement therapy

Preparation

• Patients may be instructed to hydrate well before the procedure.
• Physicians might advise patients to have a light meal beforehand.
• Review of current medications and adjustments, if necessary.
• Some patients may need pre-medication to reduce potential allergic reactions.
• Baseline blood work to assess immune function.

Procedure Description

1. Initial Assessment: The healthcare provider will assess the patient's vital signs and review medical history.
2. Preparation of Injection Site: The skin where the injection will be administered is cleaned and disinfected.
3. Administration of Hyaluronidase: Hyaluronidase is injected first to help with the dispersion and absorption of the immune globulin.
4. Injection of Immune Globulin: After the hyaluronidase, the immune globulin is injected slowly subcutaneously (under the skin). This solution contains the antibodies needed.
5. Monitoring: The patient is monitored for any adverse reactions immediately after the injection.

Tools and Equipment:

• Syringes and needles
• Hyaluronidase vial
• Immune globulin solution
• Antiseptic swabs

Anesthesia or Sedation:

• Usually, no anesthesia or sedation is required. Some local anesthetic may be used to numb the injection site.

Duration

The procedure typically takes about 1 to 2 hours, including preparation, injection, and observation time.

Setting

This procedure is generally performed in an outpatient clinic or a doctor's office.

Personnel

• Registered Nurse (RN) or Licensed Practical Nurse (LPN)
• Physician or immunologist may be present for supervision.

Risks and Complications

Common risks:

• Injection site reactions like redness, swelling, and pain
• Mild headache or fatigue

Rare risks:

• Allergic reactions
• Severe side effects like anaphylaxis
• Infection at the injection site

Benefits

• Improved immune function
• Reduced frequency and severity of infections
• Enhanced quality of life

Benefits typically become noticeable after a few weeks of regular treatment.

Recovery

• Patients can often return to their normal activities immediately.
• Apply ice to the injection site to reduce swelling, if necessary.
• Follow any instructions on medications to manage minor side effects.
• Follow-up visits to monitor progress and adjust dosage if needed.

Alternatives

• Intravenous Immune Globulin (IVIG) treatments
• Other forms of subcutaneous immunoglobulin treatments
• Oral medications or antibiotics to prevent infections

Comparison:

• IVIG may be more invasive and time-consuming as it requires IV access.
• Other subcutaneous treatments may differ in absorption and frequency.

Patient Experience

During the procedure, patients might feel a slight pinch or stinging at the injection site. There could be some discomfort due to the volume of the injected solution. Post-procedure, patients may feel some local soreness or mild itching. Pain can usually be managed with over-the-counter pain relievers, and applying a cold compress can help with swelling or redness.