Historic aspects of intravenous immunoglobulin therapy
Corresponding Author
Robert A. Good MD, PhD
Department of Pediatrics, University of South Florida/St. Petersburg, St. Petersburg, Florida
Department of Pediatrics, University of South Florida/St. Petersburg, St. Petersburg, FL 33701===Search for more papers by this authorEllen Lorenz BA
Department of Pediatrics, University of South Florida/St. Petersburg, St. Petersburg, Florida
Search for more papers by this authorCorresponding Author
Robert A. Good MD, PhD
Department of Pediatrics, University of South Florida/St. Petersburg, St. Petersburg, Florida
Department of Pediatrics, University of South Florida/St. Petersburg, St. Petersburg, FL 33701===Search for more papers by this authorEllen Lorenz BA
Department of Pediatrics, University of South Florida/St. Petersburg, St. Petersburg, Florida
Search for more papers by this authorAbstract
The earliest preparations of immunoglobulins (Ig) decreased the susceptibility of agammaglobulinemic patients to infections caused by pneumococci, Haemophilus influenzae, meningococci, streptococci, and Pseudomonas aeruginosa. Intramuscular administration of such preparations was painful and traumatic, especially for children. Ethanol-fractionated Ig could not be administered intravenously (IV) because the IgG molecules tended to aggregate and thus were more likely to produce anaphylactoid reactions. New Ig preparations, isolated at low pH (e.g., pH 4) in the presence of traces of pepsin to inhibit reaggregation, were well tolerated when administered IV. Thus a new era of treatment and prophylaxis of disease using IV Ig (IVIG) was launched. The IVIG preparations revolutionized the management of virtually all immunodeficiency syndromes characterized by failure of antibody responses. Amelioration of antibody deficiency secondary to certain chronic diseases or surgical trauma can be achieved with these preparations. Newer uses of IVIG include treatment of some autoimmune diseases; in some conditions, the beneficial influences may be attributable to antiidiotype antibodies present in the IVIG. Another likely explanation is that IVIG inhibits damage to cells and tissues by antibody-mediated cellular cytotoxicity or blocks phagocytosis that is facilitated by Fc receptor mechanisms. The value of IVIG in preventing infection in patients undergoing bone marrow or organ transplantation and in the treatment and prophylaxis of life-threatening infections in neonates and premature infants also is reviewed.
References
- 1 von Behring E, Kitasato S. Uber das zustandekommen der diptherie-immunitat und der tetanus-immunitat bei thieren. Deutsche Medizinische Wochenschrift 1890; 16: 1113–1114.
10.1055/s-0029-1207589 Google Scholar
- 2 Hericourt J, Richet C. Sur une microbe pyogene et septique (Staphylococcus pyosepticus) et sur la vaccination contre ses effets. Comptes Rendus de l'Academie des Sciences 1888; 107: 690–694.
- 3 Ehrlich P. Experimentelle untersuchungen uber immunitat: I. Uber abrin. Deutsche Medizinische Wochenschrift 1891; 17: 976–979.
10.1055/s-0029-1206682 Google Scholar
- 4 Ehrlich P. Experimentelle untersuchungen uber immunitat: II. Uber abrin. Deutsche Medizinische Wochenschrift 1891; 17: 1218–1219.
10.1055/s-0029-1206825 Google Scholar
- 5 Eibl MM, Wedgwood RJ. Intravenous immunoglobulin: A review. Immunodeficiency Review 1989; (Suppl) 1: 1–42.
- 6 Calmette A. Sur la toxicite du sang de cobra capel: L'immunisation artificielle des animaux contre le venin des serpents et al therapeutique experimentale des morsures venimeuses: Au sujet de l'attentuation des venins parle chauffage et de l'immunisation des animaux contre l'envenimation. Comptes Rendus de la Societe de Biologie 1894; 45: 204–205.
- 7 Cenci F. Alcune esperienze di sieroimmunizzazione e sieroterapia nel morbillo. Rivista di Clinica e Pediatrica 1907; 6: 1017–1025.
- 8 Nicolle C, Conseil E. Pouvoir preventif du serum d'un malade convalescent de rougeole. Bulletins et Memoires de la Societe Medicale des Hopitaux de Paris 1918; 42: 336–338.
- 9 McKhann CF, Chu FT. Use of placental extract in prevention and modification of measles. Am J Dis Child 1933; 45: 475–479.
- 10 Gibson RB. The concentration of antitoxin for therapeutic use. J Biol Chem 1906; 1: 161–170.
- 11 Karelitz S. Prophylaxis against measles with the globulin fraction of immune adult serum. Am J Dis Child 1938; 55: 768–775.
- 12 Finlayson JS. History of immunoglobulin use. In: BM Alving, JS Finlayson, eds. Immunoglobulins: Characteristics and Uses of Intravenous Preparations. Washington, DC: US Government Printing Office, ix-x, 1979. (DHHS Publication No. [FDA]-80–905).
- 13 Cohn EJ. Blood proteins and their therapeutic value. Science 1945; 101: 51–56.
- 14 Cohn EJ. The history of plasma fractionation. In: EC Andrus, DW Bronk, GA Carden, CS Keefer, JS Lockwood, JT Wearn, MC Winternitz, eds. Advances in Military Medicine, vol. 1. Boston: Little, Brown, 1948; 364–443.
- 15 Cohn EJ, Luetscher JA Jr, Oncley JL, Armstrong SH Jr, Davis BD. Preparation and properties of serum and plasma proteins. Journal of the American Chemical Society 1940; 62: 3396–3400.
- 16 Tiselius A. A new apparatus for electrophoretic analysis of colloidal mixtures. Trans Faraday Soc 1937; 33: 524–531.
- 17 Tiselius A, Kabat EA. Electrophoresis of immune serum. Science 1938; 87: 416–417.
- 18 Stokes J Jr, Maris EP, Gellis SS. Chemical, clinical and immunological studies on the products of human plasma fractionation: XI. The use of concentrated normal human serum gamma globulin (human immune serum globulin) in the prophylaxis and treatment of measles. J Clin Invest 1944; 23: 531–540.
- 19 Stokes J Jr, Neefe JR. The prevention and attentuation of infectious hepatitis by gammaglobulin. JAMA 1945; 127: 144–145.
- 20 Barandun S. Die gammaglobulin therapie. Bibliotheca Haematologica 1964; (Suppl) 17: 1–134.
- 21 Barandun S, Kistler P, Jeunet F, Isliker H. Intravenous administration of human gammaglobulin. Vox Sang 1962; 7: 157–174.
- 22 Barandun S, Riva G, Spengler GA. Immunologic deficiency diagnosis, forms and current treatment. In: D Bergsma, RA Good, eds. Immunologic Deficiency Diseases in Man. New York: The National Foundation of the March of Dimes, 1968; 40–49.
- 23 Barandun S. Replacement therapy in primary immunodeficiencies. In: A Morell, UE Nydegger, eds. Clinical Use of Intravenous Immunoglobulins. London: Academic Press, 1986; 63–66.
- 24 World Health Organization. Appropriate uses of human immunoglobulin in clinical practice: Memorandum from an IUIS/WHO meeting. WHO Bulletin 1982; 60: 43–47.
- 25 Sandoz Pharmaceuticals Corp. Sandoglobulin: Product Information Monograph. East Hanover, NJ: Sandoz, 1984.
- 26 Cutter Biologicals. Gamimmune N: Product Information Monograph. Berkeley, CA: Cutter, 1984.
- 27 Travenol Laboratories. Gammagard: Product Information Monograph. Glendale, CA: Travenol, 1985.
- 28 Hein RH, McCue JP, Hink J. Non-A, non-B hepatitis and intravenous immunoglobulin (Letter). Lancet 1985; 1: 404–405.
- 29 Wedgwood RJ. Intravenous immunoglobulin. Clin Immunol Immunopathol 1986; 40: 147–150.
- 30 Kuo G, Choo QL, Alter HJ et al. An assay for circulating antibodies to a major etiologic virus of human non-A, non-B hepatitis. Science 1989; 244: 362–364.
- 31 Centers for Disease Control. Safety of therapeutic immune globulin preparations with respect to transmission of human T-lymphotropic virus type II/lymphadenopathy-associated virus infection. MMWR 1986; 35: 231–233.
- 32 Bruton OC. Agammaglobulinemia. Pediatrics 1952; 9: 722.
- 33 Good RA, Varco RL. Clinical and experimental study of agammaglobulinemia. Lancet 1955; 1: 75: 245.
- 34 Good RA, Zak SL. Disturbances in gamma globulin synthesis as “experiments of nature.” Pediatrics 1956; 18: 109.
- 35 Good RA, Dalmasso AP, Martinez C, Archer OK, Pierce JC, Papermaster BW. The role of the thymus in development of immunologic capacity in rabbits and mice. J Exp Med 1962; 116: 773.
- 36 Cooper MD, Peterson RDA, Good RA. Delineation of the thymic and bursal lymphoid systems in the chicken. Nature 1965; 205: 143.
- 37 Cooper MD, Peterson RDA, South MA, Good RA. The functions of the thymus system and bursa system in the chicken. J Exp Med 1966; 123: 175.
- 38 Good RA, Martinez C, Gabrielsen AE. Clinical considerations of the thymus in immunobiology. In: RA Good, AE Gabrielsen, eds. The Thymus in Immunobiology. New York: Harper & Row, 1964; 3–47.
- 39 Cooper MD, Perey DY, Peterson RDA, Gabrielsen AE, Good RA. The two-component concept of the lymphoid system. In: D. Bergsma RA Good, eds. Immunologic Deficiency Diseases in Man. New York: The National Foundation of the March of Dimes, 1968; 7–12.
- 40 D Bergsma, RA Good, eds. Immunologic Deficiency Diseases in Man. New York: The National Foundation of the March of Dimes, 1968; 1–473.
- 41 Roifman CM, Gelfand EW. Replacement therapy with high-dose intravenous gammaglobulin improves chronic sinopulmonary disease in patients with hypogammaglobulinemia. Pediatr Infect Dis J 1988; 7: S92–S96.
- 42 Roifman CM, Lederman HM, Lavi S et al. Benefit of intravenous IgG replacement in hypogammaglobulinemic patients with chronic sinopulmonary disease. Am J Med 1985; 79: 171–174.
- 43 Bjorkander J, Bengtsson U, Oxelius V, Hanson LA. Symptoms in patients with lowered levels of IgG subclasses, with or without IgA deficiency, and effects of immunoglobulin prophylaxis. In: LA Hanson, T Söderström, V-A Oxelius, eds. Immunoglobulin Subclass Deficiencies. Basel: Karger, 1985; 157–164.
- 44 Jorgensen B, Andersson B, Hanson LA et al. Gamma-globulin treatment of recurrent acute otitis media in children. Pediatr Infect Dis J 1990; 9: 389–394.
- 45 Ben-Bassat I, Many A, Modan M, Peretz C, Ramot B. Serum immunoglobulins in chronic lymphocytic leukemia. Am J Med Sci 1979; 278: 4–9.
- 46 Hudson RP, Wilson SJ. Hypogammaglobulinemia and chronic lymphatic leukemia. Cancer 1960; 13: 200–204.
10.1002/1097-0142(196001/02)13:1<200::AID-CNCR2820130131>3.0.CO;2-Y CASPubMedWeb of Science®Google Scholar
- 47 Chapel H, Bunch CR. Infections in chronic lymphocytic leukemia. Semin Hematol 1987; 24: 291–296.
- 48 Cooperative Group for the Study of Immunoglobulin in Chronic Lymphocytic Leukemia. Intravenous immunoglobulin for the prevention of infection in chronic lymphocytic leukemia: A randomized, controlled clinical trial. N Engl J Med 1988; 319: 902–907.
- 49 Gordon DS, Hearn EB, Spira TJ et al. Phase I study of intravenous gamma globulin in multiple myeloma. Am J Med 1984; 76: 111–116.
- 50 Schedel I. Application of immunoglobulin preparations in multiple myeloma. In: A Morell, UE Nydegger, eds. Clinical Use of Intravenous Immunoglobulins. London: Academic, 1986; 123–132.
- 51 Amer J, Ott E, Ibbott FA, O'Brian D, Kempe H. The effect of monthly gamma-globulin administration on morbidity and mortality from infection in premature infants during the first year of life. Pediatrics 1983; 32: 4–9.
- 52 Haque KN, Zaidi MH, Haque SK, Bahakim H, El-Hazmi M, El-Swailam M. Intravenous immunoglobulin for prevention of sepsis in preterm and low birth weight infants. Pediatr Infect Dis J 1986; 5: 622–625.
- 53 Sidiropoulos D, von Muralt G. Prenatal and postnatal prophylaxis of infections in preterm neonates. Pediatr Infect Dis J 1988; 7: 572–578.
- 54 Chirico G, Rondini G, Plenbani A, Chiara A, Massa M, Ugazio AG. Intravenous gammaglobulin therapy for prophylaxis of infection in high-risk neonates. J Pediatr 1987; 110: 437–442.
- 55 Hill HR, Shigeoka AO, Gonzales LA, Christensen RD. Intravenous immune globulin use in newborns. J Allergy Clin Immunol 1989; 34: 617–623.
- 56 Shigeoka AO, Hall RT, Hill HR. Blood transfusion in group-B streptococcal sepsis. Lancet 1978; 1: 636–638.
- 57 Fischer GW, Hemming VG, Wilson SR. Enhanced clearance and protection in a group B streptococcal (GBS) sepsis model: Standard intravenous immunoglobulin (IVIG) versus human hyperimmune IVIG (GBS-IVIG) (Abstr). Presented at the 26th Interscience Conference on Antimicrobial Agents and Chemotherapy, Washington, DC, September 28–October 1, 1986.
- 58 Bohnsack JF, Hawley MM, Pritchard DG et al. An IgA monoclonal antibody directed against type III antigen on group B streptococci acts an opsonin. J Immunol 1990; 143: 3338–3342.
- 59 Kim KS, Cross AS, Zollinger W, Sadoff J. Prevention and therapy of experimental Escherichia coli infection with monoclonal antibody. Infect Immun 1985; 50: 734–737.
- 60 Bortolussi R, Fischer GW. Opsonic and protective activity of immunoglobulin, modified immunoglobulin and serum against neonatal Escherichia coli K1 infection. Pediatr Res 1986; 20: 175–178.
- 61 Pluschke G, Achtman M. Antibodies to O-antigen of lipopolysaccharide are protective against neonatal infection with Escherichia coli K1. Infect Immun 1985; 49: 365–370.
- 62 Kaufman BM, Cross AS, Futrovsky SL, Sidberry HF, Sadoff JC. Monoclonal antibodies reactive with K1-encapsulated Escherichia coli lipopolysaccharide are opsonic and protect mice against lethal challenge. Infect Immun 1986; 52: 617–619.
- 63 Cryz SJ Jr, Furer E, Germanier R. Safety and immunogenicity of Klebsiella pneumoniae K1 capsular polysaccharide vaccine in humans. J Infect Dis 1985; 151: 665–671.
- 64 Cryz SJ Jr, Cross AS, Furer E, Chariatte N, Sadoff JC, Germanier R. Activity of intravenous immune globulins against Klebsiella. J Lab Clin Med 1986; 108: 182–189.
- 65 Collins MS, Roby RE. Protective activity of an intravenous immune globulin (human) enriched in antibody against lipopolysaccharide antigens of Pseudomonas aeruginosa. Am J Med 1984; 76: 155–160.
- 66 Pollack M. Antibody activity against Pseudomonas aeruginosa in immune globulins prepared for intravenous use in humans. J Infect Dis 1983; 147: 1090–1098.
- 67 Siber GR, Ambrosino DM, McIver J et al. Preparation of human hyperimmune globulin to Haemophilus influenzae b, Streptococcus pneumoniae and Neisseria meningitidis. Infect Immun 1984; 45: 248–254.
- 68 Ambrosino D, Schreiber JR, Daum RS, Siber GR. Efficacy of human hyperimmune globulin in prevention of Haemophilus influenzae type b disease in infant rats. Infect Immun 1983; 39: 709–714.
- 69 Santosham M, Reid A, Aspery K et al. Prevention of H. influenzae type b and pneumococcal infections in high-risk infants with bacterial polysaccharide immune globulin (Abstr). Presented at the 26th Interscience Conference on Antimicrobial Agents and Chemotherapy, Washington, DC, September 28–October 1, 1986.
- 70 Barnes GL, Doyle LW, Hewson PH et al. A randomised trial of oral gammaglobulin in low-birth-weight infants infected with rotavirus. Lancet 1982; 1: 1371–1373.
- 71 Erlendsson K, Swartz T, Dwyer JM. Successful reversal of echo-virus encephalitis in X-linked hypogammaglobulinemia by intraventricular administration of immunoglobulin. N Engl J Med 1985; 312: 351–353.
- 72 Crennan JM, Van Scoy RE, McKenna CH, Smith TF. Echovirus polymyositis in patients with hypogammaglobulinemia: Failure of high-dose intravenous gammaglobulin therapy and review of the literature. Am J Med 1986; 31: 35–42.
- 73 Dagan R, Schwartz RH, Insel RA, Menegus MA. Severe diffuse adenovirus 7a pneumonia in a child with combined immunodeficiency: Possible therapeutic effect of human immune serum globulin containing specific neutralizing antibody. Pediatr Infect Dis J 1984; 3: 246–251.
- 74 Hemming VG, Prince GA, Horswood RL et al. Studies of passive immunotherapy for infections of respiratory syncytial virus in the respiratory tract of a primate model. J Infect Dis 1985; 152: 1083–1087.
- 75 Prince GA, Hemming VG, Horswood RL, Chanock RM. Immunoprophylaxis and immunotherapy of respiratory syncytial virus infection in the cotton rat. Virus Res 1985; 3: 193–206.
- 76 Hemming VG, Rodriguez W, Kim HW et al. Intravenous immunoglobulin treatment of respiratory syncytial virus infections in infants and young children. Antimicrob Agents Chemother 1987; 31: 1882–1886.
- 77 Hemming V, Prince GA, Rodriguez W et al. Respiratory syncytial virus infections and intravenous gammaglobulins. Pediatr Infect Dis J 1988; (Suppl) 7: 103–106.
- 78 Condie RM, O'Reilly RJ. Prevention of cytomegalovirus infection by prophylaxis with an intravenous, hyperimmune, native unmodified cytomegalovirus globulin: A randomized trial in bone marrow transplant recipients. Am J Med 1984; 76: 134–141.
- 79 Winston DH, Ho WG, Lin CH et al. Intravenous immunoglobulin in bone marrow transplantation. Ann Intern Med 1987; 106: 12–18.
- 80 Snydman DR, Werner BG, Heinze-Lacey B et al. Use of cytomegalovirus immune globulin to prevent cytomegalovirus disease in renal-transplant recipients. N Engl J Med 1987; 317: 1049–1054.
- 81 Emanuel D, Cunningham I, Jules-Elysee K et al. Cytomegalovirus pneumonia after bone marrow transplantation successfully treated with the combination of ganciclovir and high-dose intravenous immune globulin. Ann Intern Med 1988; 109: 777–782.
- 82 Sullivan KM, Kopecky KJ, Jocom J et al. Immunomodulatory and antimicrobial efficacy of intravenous immunoglobulin in bone marrow transplantation. N Engl J Med 1990; 323: 1705–1712.
- 83 Munster AM, Hoagland HC, Pruitt BA Jr. The effect of thermal injury on serum immunoglobulins. Ann Surg 1970; 172: 9655–9669.
- 84 Munster AM, Moran KT, Thupari J, Allo M, Winchurch RA. Prophylactic intravenous immunoglobulin replacement in high-risk burn patients. J Burn Care Rehabil 1987; 8: 376–380.
- 85 Hunt JL, Purdue GF. A clinical trial of i.v. tetravalent hyper-immune Pseudomonas globulin G in burned patients. J Trauma 1988; 28: 146–151.
- 86 Ninnemann JL. Trauma and surgery as immunosuppressive experiences. In: RA Good, E Lindenlaub, eds. The Nature, Cellular and Biochemical Basis and Management of Immunodeficiencies. Stuttgart: Schattauer, 1987; 369–398.
- 87 Glinz W, Grob PJ, Nydegger UE et al. Polyvalent immunoglobulins for prophylaxis of bacterial infections in patients following multiple trauma: A randomized, placebo-controlled study. Intensive Care Med 1985; 11: 288–294.
- 88 Imbach P, Barandun S, d'Apuzzo V et al. High-dose intravenous gammaglobulin for idiopathic thrombocytopenic purpura in childhood. Lancet 1981; 1: 1228–1230.
- 89 Mori PG, Mancuso G, Del Principe D et al. Chronic idiopathic thrombocytopenia treated with immunoglobulin. Arch Dis Child 1983; 58: 851–855.
- 90 Oral A, Nusbacher J, Hill JB, Lewis JH. Intravenous gamma globulin in the treatment of chronic idiopathic thrombocytopenic purpura in adults. Am J Med 1984; 76: 187–192.
- 91 Pollak AN, Janinis J, Green D. Successful intravenous immune globulin therapy for human immunodeficiency virus-associated thrombocytopenia. Arch Intern Med 1988; 148: 695–697.
- 92 Gaedicke G, Teller WM, Kahne E et al. IgG therapy in systemic lupus erythematosus: Two case reports. Blut 1984; 48: 387–390.
- 93 Gelfand EW. The use of intravenous immune globulin in collagen vascular disorders: A potentially new modality of therapy. J Allergy Clin Immunol 1989; 84: 613–616.
- 94 Savery F. Immunodeficiency associated with rheumatoid arthritis treated with intravenous immunoglobulin. Clin Ther 1988; 10: 527–529.
- 95 Silverman ED, Laxer RM, Greenwald M et al. Intravenous gamma globulin therapy in systemic juvenile rheumatoid arthritis. Arthritis Rheum 1990; 33: 1015–1022.
- 96 Bussel JB, Cunningham-Rundles C, Abraham C. Intravenous treatment of autoimmune hemolytic anemia with very high dose gammaglobulin. Vox Sang 1986; 51: 265–269.
- 97 Richmond GW, Ray I, Korenblitt A. Initial stabilization preceding enhanced hemolysis in autoimmune hemolytic anemia treated with intravenous gammaglobulin. J Pediatr 1987; 110: 917–919.
- 98 Pollack S, Cunningham-Rundles C, Smithwick EM, Barandun S, Good RA. High-dose intravenous gammaglobulin in autoimmune neutropenia (Letter). N Engl J Med 1982; 307: 253.
- 99 Sultan Y, Maisonneuve P, Kazatchkine MD, Nydegger UE. Anti-idiotypic suppression of autoantibodies to factor VIII (antihaemophilic factor) by high-dose intravenous gammaglobulin. Lancet 1984; 2: 765–768.
- 100 Roifman CM, Schaffer FM, Wachsmuth SE, Murphy G, Gelfand EW. Reversal of chronic polymositis following intravenous immune serum globulin therapy. JAMA 1987; 258: 513–515.
- 101 Gelfand EW. The use of intravenous immune globulin in collagen vascular disorders: A potentially new modality of therapy. J Allergy Clin Immunol 1989; 21: 615–616.
- 102 Faed JM, Day B, Pollock M, Taylor PK, Nukada H, Hammond-Tooke GD. High-dose intravenous human immunoglobulin in chronic inflammatory demyelinating polyneuropathy. Neurology 1989; 39: 422–425.
- 103 Vermeulen M, van der Maeche FG, Speelman JD, Weber A, Busch JF. Plasma and gamma-globulin infusion in chronic inflammatory polyneuropathy. J Neurol Sci 1985; 70: 317–326.
- 104 Urval K, Nelson RP, Cohen SR, Good RA. Treatment of chronic inflammatory demyelinating polyneuropathy (CIDP) recalcitrant to conventional therapy with intravenous immunoglobulin. South Med J (in press).
- 105 Newburger JW, Takahashi M, Burns JC et al. Treatment of Kawasaki syndrome with intravenous gamma globulin. N Engl J Med 1986; 315: 341–346.
- 106 Arsura EL, Bick A, Brunner NG, Namba T, Grob D. High-dose intravenous immunoglobulin in the management of myasthenia gravis. Arch Intern Med 1986; 146: 1365–1368.
- 107 Cook L, Howard JF Jr, Folds JD. Immediate effects of intravenous IgG administration on peripheral blood B and T cells and poly-morphonuclear cells in patients with myasthenia gravis. J Clin Immunol 1988; 8: 23–31.
- 108 Kleyweg RP, van der Meche FGA, Meulstee J. Treatment of Guillain-Barré syndrome with high dose gammaglobulin. Neurology 1990; 38: 1639–1641.
- 109 Tobi M, Straus SE. Chronic Epstein-Barr virus disease: A workshop held by the National Institute of Allergy and Infectious Diseases. Ann Intern Med 1985; 103: 951–953.
- 110 Gupta A, Novick BE, Rubinstein A. Restoration of suppressor T-cell functions in children with AIDS following intravenous gamma-globulin treatment. Am J Dis Child 1986; 140: 143–146.
- 111 Calvelli TA, Rubinstein A. Intravenous gamma-globulin in infant acquired immunodeficiency syndrome. Pediatr Infect Dis J 1986; 5: S207–S210.
10.1097/00006454-198605010-00014 Google Scholar
- 112 Karpas A, Hill F, Youle M et al. Effects of passive immunization in patients with the acquired immunodeficiency syndrome-related complex and acquired immunodeficiency syndrome. Proc Natl Acad Sci U S A 1988; 85: 9234–9237.