Products with low IgA content may be used in patients with total IgA deficiency

doi:10.1136/bmj.313.7069.1400

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Siraj Misbah

Consultant clinical immunologist Department of Chemical Pathology and Immunology, Institute of Pathology, Leeds General Infirmary, Leeds LS1 3EX

EDITOR,—R A C Hughes emphasises that, on the basis of the results of recent randomised studies, intravenous immunoglobulin is as efficacious as plasmapheresis in the treatment of the Guillain-Barre syndrome.1 In view of the practical difficulties associated with plasmapheresis, intravenous immunoglobulin is increasingly likely to be preferred as first line treatment.

In this context Hughes states that intravenous immunoglobulin should be avoided in patients with IgA deficiency. This may mislead clinicians who are unfamiliar with immunoglobulin treatment and may result …