From the Research
Yes, intravenous immunoglobulin (IVIG) products can contain hemagglutinins, which are antibodies that can cause red blood cells to clump together. IVIG is derived from pooled human plasma from thousands of donors, and these donors may have antibodies against blood group antigens, particularly anti-A and anti-B hemagglutinins. The concentration of these hemagglutinins varies between different IVIG preparations and manufacturing processes. This is clinically significant because when IVIG is administered to patients with blood types A, B, or AB, these hemagglutinins can potentially cause hemolysis (destruction of red blood cells) 1. Key factors that increase the risk of hemolysis include:
- High-dose IVIG therapy
- Non-O blood types
- Underlying inflammatory conditions For this reason, patients receiving IVIG should be monitored for signs of hemolysis such as back pain, decreased hemoglobin, or darkened urine, particularly within the first 48 hours after infusion 2, 3. Some newer IVIG preparations undergo additional processing steps to reduce hemagglutinin content, making them potentially safer for patients at higher risk of hemolytic reactions. It is essential to be aware of the potential for clinically significant hemolysis after the use of moderate cumulative doses of IVIG, particularly in patients with risk factors for hemolysis 4, 5.