increased if no side effects occur. The infusion may take several hours. IVIG is usually given in the infusion unit or a hospital. A nurse will monitor your child for side effects. Most reactions to IVIG occur during the infusion, and some side effects may occur 1–3 days after the infusion. Your child may be given diphenhydr - amine (Benadryl®) or acetaminophen (Tylenol®) before the IVIG infusion to decrease the chance of side effects. Common side effects of IVIG include • headache • fever or chills • nausea or vomiting • hives or rash
• feeling tired (fatigue) • muscle or joint pain.
There is a small chance that your child may have a severe allergic reaction to IVIG. If this happens, the infusion is stopped and medications to treat the allergic reaction are given immediately. There is a very small risk that the IVIG may contain viruses that cause infection.
IVIG may prevent some live vaccines from being effective. Live vaccines used to immunize children against diseases like measles, mumps, and rubella (MMR) and chickenpox should not be given for several months after a child receives IVIG. Steroids (Glucocorticoid Steroid Hormones) Steroids, which are natural substances made by the body, are important for many body functions. One steroid is cortisone , a chemical made by the adrenal glands (small organs above the kidneys). Prednisone and dexametha- sone are synthetic (man-made) medicines that are similar to cortisone. These types of steroids are different from the anabolic steroids that are used to build muscles. It is not clear how steroids work to treat ITP, but they may decrease the number of antibodies being made against the platelets and may slow the rate at which the antibody-coated platelets are removed by the spleen. Steroids may also make the blood vessels more stable, lowering the risk of bleeding. Steroids do not cure ITP, but they increase the platelet count in more than 75% of children with ITP. If the body is still making antibodies against the platelets when the steroid dose is decreased or stopped, the platelet count may drop again. Typically, steroids are given by mouth as a pill or a liquid. Your child’s healthcare provider will prescribe how much medicine should be taken. Steroids may be given orally (by mouth) in different ways: • in very high doses over a few days • in high doses for several days followed by a special dosing schedule to stop the medication by slowly decreasing the amount taken (a taper) • in low doses for several weeks or months. Make sure that you understand how to give the medicine and what to do if your child refuses the medicine or vomits a dose.
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