persistent purulent suppurative otitis media disease or bronchiectasis. An immunoglobulin threatening long-term hearing) washout period of four to six months is necessary to enable an accurate assessment. AND Prophylactic antibiotics may be considered to cover the period of IVIg cessation. A trial cessation of therapy will be undertaken next September or October to undertake an Patients may qualify for further IVIg therapy: immunological re-evaluation, unless a period of cessation of intravenous under other immunodeficiency immunoglobulin (IVIg) for the purpose of immunological evaluation is medically criteria (e.g. common variable contraindicated on safety grounds (such as a immunodeficiency [CVID]) depending patient with neutropenia, on on the results of subsequent immune immunosuppressant medication or with evaluation; or clinically active bronchiectasis and/or suppurative lung disease*). rarely under specific antibody deficiency following re-emergence of severe significant infection requiring *Please note: a diagnosis of bronchiectasis hospitalisation. and/or suppurative lung disease must be consistent with the position statement of the In principle, IVIg should only be continued or Thoracic Society of Australia and New Zealand renewed if there is a demonstrated clinical and the Australian Lung Foundation (Chang et al benefit. 2010). Note that re-vaccination with pneumococcal polysaccharide vaccine is not recommended Life-threatening infection or a series of because of safety concerns, and the potential significant infections following trial-off Ig therapy
disease or bronchiectasis. An immunoglobulin washout period of four to six months is necessary to enable an accurate assessment. Prophylactic antibiotics may be considered to cover the period of IVIg cessation. Patients may qualify for further IVIg therapy: under other immunodeficiency criteria (e.g. common variable immunodeficiency [CVID]) depending on the results of subsequent immune evaluation; or rarely under specific antibody deficiency following re-emergence of severe significant infection requiring hospitalisation. In principle, IVIg should only be continued or renewed if there is a demonstrated clinical benefit. Note that re-vaccination with pneumococcal polysaccharide vaccine is not recommended because of safety concerns, and the potential persistent purulent suppurative otitis media threatening long-term hearing) AND A trial cessation of therapy will be undertaken next September or October to undertake an immunological re-evaluation, unless a period of cessation of intravenous immunoglobulin (IVIg) for the purpose of immunological evaluation is medically contraindicated on safety grounds (such as a patient with neutropenia, on immunosuppressant medication or with clinically active bronchiectasis and/or suppurative lung disease*). *Please note: a diagnosis of bronchiectasis and/or suppurative lung disease must be consistent with the position statement of the Thoracic Society of Australia and New Zealand and the Australian Lung Foundation (Chang et al 2010). Life-threatening infection or a series of significant infections following trial-off Ig therapy
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