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Safety of intravenous immunoglobulin.

The current position of intravenous immunoglobulin (IVIG) in neurology is similar to that of plasmapheresis 10 years ago. Therapeutic claims have been made for an increasing number of neurologic disorders, based on small, uncontrolled studies. With the recent publication of a controlled trial of IVIG treatment in Guillain-Barre syndrome, 1 and trials in chronic inflammatory demyelinating polyneuropathy and inflammatory myopathy in progress or nearing completion, increasing use of IVIG by neurologists can be expected. A major factor fueling the current interest in IVIG is its relative safety. It is regarded by some as "virtually riskless." 2 Even so, potential toxicity should be considered when evaluating therapeutic claims and prescribing IVIG treatment. Commercial IVIG is human IgG prepared from the pooled plasma of 2000 to 10000 or more donors to maximize the diversity of antibodies of the final product. Because the antibody repertoire of the species is much larger than that