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IVIG has a number of immunosuppressive and antiinflammatory properties that include modulation of immunoglobulin G (IgG) levels, lymphocyte and reticuloendothelia function, cytokine production, complement regulation, and clearance of pathogenic IgG. IVIG provides adequate concentrations of antibodies against a broad range of pathogens for patients with hypogammaglobulinemia, antibody deficiency disorders, other immunodeficiency states, and certain infections.

For most patients, we obtain pretreatment laboratory testing that includes a complete blood count (CBC), hepatic transaminases, metabolic panel including glucose, serum creatinine, and urinalysis before initiating IVIG. Patients with abnormalities in this testing may require additional evaluation. 

IVIG is produced from pooled plasma donated by several thousand screened donors. Numerous quality control procedures and manufacturing standards are in place to ensure highly purified and stable solutions, although slight differences exist in different products. Choices among products depend on patient and disease factors as well as clinical judgment. Importantly, patients who require a specific type of hyperimmune globulin should receive a product intended for this purpose rather than IVIG. Once a patient has found an IVIG product that is well tolerated, it is advisable not to change products unless there is a compelling reason to do so. 

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