A 10% liquid immunoglobulin preparation for intravenous use (Privigen®) in paediatric patients with primary immunodeficiencies and hypersensitivity to IVIG

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Vieira, L. Cunha, E. Neves, H. Falcão" "autores" => array:4 [ 0 => array:2 [ "nombre" => "T." "apellidos" => "Vieira" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Cunha" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Neves" ] 3 => array:2 [ "nombre" => "H." "apellidos" => "Falcão" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0301054612002753?idApp=UINPBA00004N" "url" => "/03010546/0000004200000002/v1_201403270032/S0301054612002753/v1_201403270032/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "A 10% liquid immunoglobulin preparation for intravenous use (Privigen®) in paediatric patients with primary immunodeficiencies and hypersensitivity to IVIG" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "136" "paginaFinal" => "141" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. Lozano-Blasco, M.A. Martín-Mateos, L. Alsina, O. Domínguez, M.T. Giner, M. Piquer, M. Alvaro, A.M. Plaza" "autores" => array:8 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Lozano-Blasco" ] 1 => array:4 [ "nombre" => "M.A." "apellidos" => "Martín-Mateos" "email" => array:1 [ 0 => "martinmateos@hsjdbcn.org" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "¿" "identificador" => "cor0005" ] ] ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Alsina" ] 3 => array:2 [ "nombre" => "O." "apellidos" => "Domínguez" ] 4 => array:2 [ "nombre" => "M.T." "apellidos" => "Giner" ] 5 => array:2 [ "nombre" => "M." "apellidos" => "Piquer" ] 6 => array:2 [ "nombre" => "M." "apellidos" => "Alvaro" ] 7 => array:2 [ "nombre" => "A.M." "apellidos" => "Plaza" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Pediatric Allergy and Clinical Immunology Department of Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Barcelona, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1909 "Ancho" => 1583 "Tamanyo" => 362446 ] ] "descripcion" => array:1 [ "en" => "Schedule of adapted ultra-slow infusion protocol." ] ] ] "textoCompleto" => "IntroductionGammaglobulin is a standard and life-saving therapy in primary immunodeficiencies (PID) as well as in diseases dealing with immunoglobulin dysregulation such as neoplasia or autoimmune disorders.<a class="elsevierStyleCrossRef" href="#bib0005">1</a>The discovery, 50 years ago, that immunoglobulin replacement therapy decreased the susceptibility to infection in patients with PID has led to ongoing efforts to develop better, safer and more comfortable formulations.<a class="elsevierStyleCrossRef" href="#bib0010">2</a> Replacement of missing IgG antibodies has been shown to reduce the frequency and severity of infections.<a class="elsevierStyleCrossRefs" href="#bib0015">3–5</a>There are currently a number of products that provide chemically unmodified lyophilised powders or liquid concentrates of polyclonal IgG; these products are produced from plasma recovered from whole blood donations, or more commonly from a large number of plasmapheresis donors.<a class="elsevierStyleCrossRef" href="#bib0030">6</a> Although all these intravenous immunoglobulin (IVIG) end products are composed of high IgG concentrations, variations in manufacturing processes lead to unique product characteristics.<a class="elsevierStyleCrossRef" href="#bib0035">7</a> In recent years, new formulations with IgG concentration of 10% have appeared aiming at decreasing the time of administration. Indeed, the rate at which IVIG can be administered can have a significant impact on patient time saving and health service use.<a class="elsevierStyleCrossRef" href="#bib0040">8</a> Likewise, liquid IVIG, as opposed to lyophilised products which require reconstitution,<a class="elsevierStyleCrossRefs" href="#bib0045">9,10</a> are gaining support. Comparative studies between liquid and lyophilised formulations of IVIG have been published.<a class="elsevierStyleCrossRef" href="#bib0055">11</a> They concluded that liquid formulations were therapeutically equivalent and equally well tolerated to lyophilised formulations but in a more convenient ready-to-use dosage form that may also reduce preparation errors.<a class="elsevierStyleCrossRef" href="#bib0055">11</a>Despite the clear benefit of IVIGs for patients, concern exists about adverse events that keep being reported.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> Most of these are infusion reactions that are related to the rate of infusion. When evaluating different formulations,<a class="elsevierStyleCrossRefs" href="#bib0010">2,8,12</a> it was found that IgG dimers were associated with infusion reactions,<a class="elsevierStyleCrossRefs" href="#bib0045">9,13–15</a> and clinical tolerability of IVIG products was improved by reducing the presence of IgG dimers in IVIG formulations.Privigen® is a 10% liquid preparation of polyvalent human IgG for intravenous administration. It was licensed in Europe in 2008.<a class="elsevierStyleCrossRef" href="#bib0080">16</a> Stabilisation with l-proline at pH 4.8 is a unique feature of this formulation, in that it minimises the formation of IgG dimers and preserves IgG functional activity without refrigeration.<a class="elsevierStyleCrossRefs" href="#bib0065">13,14,17,18</a>Over the last five years, our institution has been using two 10% IVIG with different product characteristics: Privigen® has been used from June 2009 onwards. Previously a different 10% IVIG was used, which used glycine as a stabiliser. Both are in liquid form.<a class="elsevierStyleCrossRef" href="#bib0095">19</a> IgG levels and subclass distribution are similar in both products, as well as IgA and IgM levels.<a class="elsevierStyleCrossRefs" href="#bib0095">19,20</a>A subgroup of patients who are being followed in our outpatient clinic for primary immunodeficiencies and who are highly sensitive to previous IVIG, have been treated sequentially with the two IVIG products. The objective of the present study was to evaluate safety and efficacy of the 10% liquid immunoglobulin preparation for intravenous use (Privigen®) in this particular group of paediatric patients affected with Primary Immunodeficiencies using a particular infusion protocol slower than recommended (and retrospectively compare the results to a different IVIG formulation).Materials and methodsProductPrivigen® is a ready-to-use 10% liquid formulation of polyvalent human IgG for intravenous administration that is stable at room temperature for its entire shelf-life. The naturally occurring amphiphilic amino acid l-proline (250mmol/L=28.8mg/mL) is used as stabiliser at pH 4.8. Privigen® has an IgG content of 99.2%, with more than 99.8% monomers and dimers (dimer content is typically 6%). The IgG fraction from plasma is purified by a combination of cold ethanol fractionation, octanoic acid precipitation and anion exchange chromatography. The manufacturing process includes two dedicated viral clearance steps (pH 4 incubation and nanofiltration) and two partitioning steps with validated viral clearance characteristics. Privigen® contains no preservative, has a low sodium content (≤1mmol/L) and osmolality (320±9mOsm/kg) is in the physiological range. Only trace amounts of IgA are present (8.6±1.8μg/mL).<a class="elsevierStyleCrossRef" href="#bib0090">18</a>The previous IVIG used was also a 10% liquid form, but glycine was used as stabiliser instead. The maximum IgA content was 140μg/ml and the IgG content was at least of 98%. It required be stored in a refrigerator (2–8°C).<a class="elsevierStyleCrossRef" href="#bib0095">19</a>PatientsThe present work was undertaken in the Paediatric Allergy and Clinical Immunology Department of Hospital Sant Joan de Déu, a Tertiary-level Multi-speciality Mother and Child Hospital. Eight patients were included (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). They had a diagnosis of Primary Immune Deficiency, according to the International Union of Immunological Societies Expert Committee classification <a class="elsevierStyleCrossRef" href="#bib0105">21</a>: Common Variable Immunodeficiency (CVID) (four patients), and other humoral deficiencies (four patients). All of them had been switched from the previous 10% IVIG formulation to Privigen® in an open protocol due to severe and/or recurrent adverse events, despite premedication and reduction of infusion rate.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Study designData were prospectively collected regarding Privigen® administration: infusion (dose, rate, total time, and interval), safety (interview with parents and patients about adverse events during the infusion and, by telephone, 72h later; use of premedication or rescue medication) and efficacy (measurement of trough levels before first administration and after three doses of Privigen®; clinical efficacy was assessed by questionnaire and chart review – use of antibiotics and severe infections while under Privigen®). In parallel, data on safety and tolerance were retrospectively collected from medical charts regarding the previous 10% IVIG product used.Administration protocolThe infusion rate used for this particularly susceptible group of patients was lower than the recommended by the manufacturer (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>): in the first administration, the initial rate was 0.16mg/kg/min (instead of the recommended 0.5mg/kg/min). The rate was increased 60min later to 0.33mg/kg/min if no reaction been observed, and was kept for 60min. Then an increase to 0.5mg/kg/min, 1 and 2mg/kg/min in 30min intervals, followed, if tolerated. If no reaction was observed 72h after administration, the second infusion was started at 0.5mg/kg/min, and increased to 1 and 2mg/kg/min (maximum rate) every 60min. The third and fourth infusions were started at 0.5mg/kg/min, which were doubled every 60min to a maximum of 4mg/kg/min and 8mg/kg/min, respectively. After the fifth infusion, the rates were increased every 30min, if tolerated.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Premedication useThe patients who were routinely given premedication with the previous 10% IVIG, were given the same premedication with the first dose of Privigen®. Premedication was stopped if Privigen® was well tolerated.ResultsEight patients with humoral PID (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>) were followed for a minimum of six months under Privigen®. Median age was 11 years old (3.5–17.9 years), and 75% were male. Four patients carried a diagnosis of CVID.All patients had previously been under IVIG treatment with another 10% liquid formulation for a minimum of one year and a maximum of three years. A median of 23.6 doses per patient had been administered (range: 14–34doses/patient). IVIG replacement dose was 475mg/kg/dose (range 300–600mg/kg/dose), every four weeks for all patients except one (every three weeks). All patients had suffered adverse events during IVIG infusion (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>), being severe in three patients (seizures, severe headache and anaphylactic-like reactions), and recurrent in the rest (headache, vomits, cough). In five patients (62.5%) adverse events also occurred 24–48h after infusion, and included headache (three patients), pyrexia (two patients), general aches (one patient) and abdominal pain (one patient). 50% of the patients received premedication systematically.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>All patients were switched to Privigen® in an open protocol due to severe or repeated adverse events related to IVIG infusion. The same dose and interval were used with the two different formulations. Premedication was given before the first Privigen® infusion to those patients that were receiving it with the previous IVIG. After the second infusion, this premedication could be withdrawn in all patients. A median of 6.6 doses per patient (range 5–9 doses/patient) was administered during the follow up.Adverse events were registered in three patients (37.5%): two patients during the first Privigen® infusion (pyrexia and headache) (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). In all cases, symptoms were mild and were controlled with the use of acetaminophen and dexchlorpheniramine, and they ceased in subsequent infusions.Two other patients had reactions 24–48h after the infusion. One referred a mild headache that resolved in 30min without medication. The other referred fatigue for 24h, but was able to perform regular activity. She had had serious adverse events under the previous IVIG. In summary, all reactions (during and or after Privigen®) were mild and did not need premedication.At the end of the study, the median time of administration was 3.3h/dose/patient (range 2.5–4h/dose/patient), with a median infusion dose of 6.4mg/kg/min (range of 3.3–8mg/kg/min), shorter than that to previous IVIG. No patient was in need of premedication. Five patients reached the maximum recommended dose of 8mg/kg/min.During the six-month-follow-up on Privigen®, no patient developed a severe infection requiring hospitalisation. No antibiotics were needed to treat mild infections. Median IgG trough levels after the third dose of Privigen® were similar to those reached with the previous IVIG (median IgG 7700mg/L and 7400mg/L, respectively) (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>), with the same dose being administered for both products. In all patients, trough levels were above 5500mg/L.<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>DiscussionThis study confirmed both safety and efficacy of Privigen® for paediatric use in PID. Also, to our understanding, this is the first study to evaluate the use of Privigen® in a subgroup of paediatric PID patients who are highly sensitive (that do not tolerate previous IVIG infusions). We show that Privigen® is suitable for these patients with low tolerance to other IVIG products. Furthermore, this product would also be convenient as a starting replacement therapy.Most patients included in the study were diagnosed of CVID. This is in accordance with a recent survey by the Immune Deficiency Foundation which indicated that patients with CVID and agammaglobulinaemia represent approximately 77% of PID patients currently receiving IVIG replacement therapy.<a class="elsevierStyleCrossRef" href="#bib0110">22</a> Doses and administration intervals were also as per current practice.In this work we have devised an open and adapted infusion protocol for this especially sensitive group of patients to IVIG products: the infusion rate was slower than recommended by the manufacturer. This protocol was effective: indeed, all patients suffered only from very mild adverse reactions, none needed premedication, and in five patients, the maximum infusion rate recommended by the manufacturer (8mg/kg/min) could be reached. Median time needed to administer Privigen® doses was 3.3h (range 2.5–4h/dose/patient), which was significantly reduced compared to the previous IVIG.<a class="elsevierStyleCrossRef" href="#bib0115">23</a> This reduction in the time of administration was particularly appreciated by patients and parents to decrease school and work absenteeism, respectively.The number of patients suffering adverse events during Privigen® (11.3%), was not only reduced compared to the previous 10% IVIG, but also compared to what is published related to Privigen® (21%) <a class="elsevierStyleCrossRefs" href="#bib0040">8,10,24</a> and other IVIG products (24.9% and 29.1%),<a class="elsevierStyleCrossRefs" href="#bib0125">25,26</a> despite reaching maximum infusion rates. Besides, the reactions referred were all mild (low pyrexia, headache), compared to the severe reactions the same patients had had with the previous IVIG, that were all limiting to their daily lives. These reactions all disappeared in the following injections, as expected,<a class="elsevierStyleCrossRef" href="#bib0135">27</a> and no patient needed premedication after the second Privigen® infusion. The most frequent adverse event was headache, as published with Privigen® in another group of patients <a class="elsevierStyleCrossRef" href="#bib0050">10</a> and with other IVIG products.<a class="elsevierStyleCrossRefs" href="#bib0125">25,26</a>This study has a clear limitation in that the retrospective data obtained from the previous 10% IVIG product cannot be directly compared to the prospective data collected for Privigen®. Besides, the protocol is open and not double blinded. Despite these limitations, this adapted infusion protocol with Privigen® shows a clear tendency towards a safer profile compared to the previous IVIG, at least in these first six months of follow-up.As for efficacy, it is general consensus that IgG trough levels should be above 5000mg/L,<a class="elsevierStyleCrossRefs" href="#bib0030">6,28–30</a> as is observed in all of our patients, after using a standard infusion dose of 400–600mg/kg every 3–4 weeks. These trough levels were even slightly higher compared to the previous IVIG, using the same replacement dose and interval (median trough IgG 7700mg/L and 7400mg/L, for Privigen® and previous IVIG, respectively).ConclusionsThe present work shows that this novel 10% liquid IVIG was safe in a special group of paediatric patients who did not tolerate the administration of a previous 10% liquid IVIG. The number of adverse effects was smaller than published, and all cases were mild. No premedication was needed. Privigen® was also effective in this small group, with IgG trough levels being stable and in the higher range, along with no infections clinically. The combination of well-tolerated high infusion rates and convenience of use due to liquid presentation and room temperature storage would be potentially advantageous for both patients and healthcare personnel.Ethical disclosuresProtection of human and animal subjectsThe authors declare that no experiments were performed on humans or animals for this investigation.Confidentiality of dataThe authors declare that no patient data appear in this article.Right to privacy and informed consentThe authors declare that no patient data appears in this article.Conflict of interestThe authors have no conflict of interest to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:2 [ "identificador" => "xres325681" "titulo" => array:5 [ 0 => "Abstract" 1 => "Background" 2 => "Material and methods" 3 => "Results" 4 => "Conclusion" ] ] 1 => array:2 [ "identificador" => "xpalclavsec307259" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 3 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Product" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Patients" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Study design" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Administration protocol" ] 4 => array:2 [ "identificador" => "sec0035" "titulo" => "Premedication use" ] ] ] 4 => array:2 [ "identificador" => "sec0040" "titulo" => "Results" ] 5 => array:2 [ "identificador" => "sec0045" "titulo" => "Discussion" ] 6 => array:2 [ "identificador" => "sec0050" "titulo" => "Conclusions" ] 7 => array:3 [ "identificador" => "sec0055" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0060" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0065" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0070" "titulo" => "Right to privacy and informed consent" ] ] ] 8 => array:2 [ "identificador" => "sec0075" "titulo" => "Conflict of interest" ] 9 => array:2 [ "identificador" => "xack77071" "titulo" => "Acknowledgement" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2012-07-31" "fechaAceptado" => "2012-10-26" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec307259" "palabras" => array:5 [ 0 => "Adverse events" 1 => "Efficacy" 2 => "Intravenous immunoglobulin" 3 => "Paediatrics" 4 => "Primary immunodeficiency" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "BackgroundThe objective of this study was to evaluate safety and efficacy of Privigen®, a 10% intravenous immunoglobulin (IVIG), in a particular group of paediatric patients (highly sensitive to previous IVIG infusion) affected with Primary Immunodeficiencies (PID). Material and methodsPatients (n=8) from 3 to 17 years old diagnosed of PID who often suffered from adverse events related to the infusion to previous IVIG were switched to Privigen® in an open protocol. Data were prospectively collected regarding Privigen® administration: infusion, safety and efficacy. In parallel, data on safety and tolerance were retrospectively collected from medical charts regarding the previous 10% IVIG product used. Results50% of the patients required premedication with previous IVIG. At the end of the study none required premedication with Privigen®. The infusion rate was lower than that recommended by the manufacturer. All patients had suffered through adverse events during previous IVIG infusion being severe in three patients and recurrent in the rest. With Privigen® only three patients suffered from an adverse event (all cases were milder than previous related). Trough levels of IgG remained stable. None suffer from any episode of bacterial infection. ConclusionThe present work shows that Privigen® was safe in a group of hypersensitive paediatric patients who did not tolerate the administration of a previous 10% liquid IVIG by using a particular infusion protocol slower than recommended. The number of adverse effects was smaller than published, and all cases were mild. No premedication was needed. Privigen® was also effective in this small group." ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1909 "Ancho" => 1583 "Tamanyo" => 362446 ] ] "descripcion" => array:1 [ "en" => "Schedule of adapted ultra-slow infusion protocol." ] ] 1 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Patient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Age (year, months) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Gender \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Diagnosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Ethnicity \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Weight (kg) \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17.11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">♀ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CVID \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Caucasian \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">55 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">♂ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CVID \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Caucasian \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">♂ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Impaired polysaccharide responsiveness \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Caucasian \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">♂ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hyper IgM Syndrome \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Caucasian \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17.10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">♀ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CVID \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Caucasian \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">♂ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Agammaglobulinaemia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Caucasian \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">♂ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Transient hypogammaglobulinaemia of infancy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Caucasian \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">♂ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CVID \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Caucasian \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">49 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Summary \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Median age: 11 year and 1 month \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">75% ♂25% ♀ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 patients: CVID4 patients: other humoral deficiencies \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% Caucasian \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Median weight: 36.75kg \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab474711.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Demographic patient characteristics." ] ] 2 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Privigen®</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Previous IVIG</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">AE<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> during infusion \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">AE<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> after infusion to 72h \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Premedication \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">AE<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> during infusion \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">AE<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a> after infusion to 72h \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Premedication \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cough, pyrexia and headache<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fatigue<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Headache, sweating, abdominal pain \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Yes \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mild headache<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Headache \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pyrexia<a class="elsevierStyleCrossRef" href="#tblfn0010">b</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Chills, pyrexia and general aches \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Yes \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cough and vomits \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Yes \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Seizures \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Yes \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cough and itchy throat \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pyrexia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Headache \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab474713.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "AE: Adverse event" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "Resolved after second infusion" ] ] ] "descripcion" => array:1 [ "en" => "Summary of adverse events." ] ] 3 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Patient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Total dose (g) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Dose (mg/kg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Interval (weeks) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">IgG (mg/L) previous IVIG<a class="elsevierStyleCrossRef" href="#tblfn0015">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">IgG (mg/L) Privigen®<a class="elsevierStyleCrossRef" href="#tblfn0020">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">400 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5474 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5890 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">320 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6476 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7163 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">400 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6711 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8226 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td 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Serum levels of IgG." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Safety of IGIV therapy and infusion-related adverse events" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Ballow" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Immunol Res" "fecha" => "2007" "volumen" => "38" "paginaInicial" => "122" "paginaFinal" => "132" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17917017" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Plasma infusions in immunologic deficiency states: metabolic and therapeutic studies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E.R. Stiehm" 1 => "J.P. Vaerman" 2 => "H.H. Fudenberg" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "1996" "volumen" => "28" "paginaInicial" => "918" "paginaFinal" => "937" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5959479" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Use of intravenous gamma-globulin in antibody immunodeficiency: results of a multicenter controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.J. Ammann" 1 => "R.F. Ashman" 2 => "R.H. Buckley" 3 => "W.R. Hardie" 4 => "H.J. Krantmann" 5 => "J. Nelson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Immunol Immunopathol" "fecha" => "1982" "volumen" => "22" "paginaInicial" => "60" "paginaFinal" => "67" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6749355" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The use of intravenous immune globulin in immunodeficiency diseases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.H. Buckley" 1 => "R.I. Schiff" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM199107113250207" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "1991" "volumen" => "325" "paginaInicial" => "110" "paginaFinal" => "117" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2052044" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy of intravenous immunoglobulin in primary humoral immunodeficiency disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Cunningham-Rundles" 1 => "F.P. Siegal" 2 => "E.M. Smithwick" 3 => "A. Lion-Boulé" 4 => "S. Cunningham-Rundles" 5 => "J. O’Malley" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Intern Med" "fecha" => "1984" "volumen" => "101" "paginaInicial" => "435" "paginaFinal" => "439" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6206756" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary Immunodeficiency Committee of the American Academy of Allergy, Asthma and Immunology. Use of intravenous immunoglobulin in human disease: a review of evidence by members of the Primary Immunodeficiency Committee of the American Academy of Allergy, Asthma and Immunology" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.S. Orange" 1 => "E.M. Hossny" 2 => "C.R. Weiler" 3 => "M. Ballow" 4 => "M. Berger" 5 => "F.A. Bonilla" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Allergy Clin Immunol" "fecha" => "2006" "volumen" => "117" "paginaInicial" => "525" "paginaFinal" => "552" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A newer immunoglobulin intravenous (IGIV) – Gammard liquid 10%: evaluation of efficacy, safety, tolerability and impact on patient care" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S.R. Shah" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1517/14712598.8.6.799" "Revista" => array:6 [ "tituloSerie" => "Expert Opin Biol Ther" "fecha" => "2008" "volumen" => "8" "paginaInicial" => "799" "paginaFinal" => "804" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18476791" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tolerability of a new 10% liquid immunoglobulin for intravenous use, Privigen®, at different infusion rates" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.W. Sleasman" 1 => "C.M. Duff" 2 => "T. Dunaway" 3 => "M.A. Rojavin" 4 => "M.R. Stein" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10875-010-9373-x" "Revista" => array:6 [ "tituloSerie" => "J Clin Immunol" "fecha" => "2010" "volumen" => "30" "paginaInicial" => "442" "paginaFinal" => "448" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20217199" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "l-Proline-stabilized human IgG: Privigen® 10% for intravenous use and Hizentra® 20% for subcutaneous use" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Berger" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2217/imt.10.108" "Revista" => array:6 [ "tituloSerie" => "Immunotherapy" "fecha" => "2011" "volumen" => "3" "paginaInicial" => "163" "paginaFinal" => "176" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21322757" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "IgPro10 in PID study group: safety and efficacy of Privigen, a novel 10% liquid immunoglobulin preparation for intravenous use, in patients with primary immunodeficiencies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.R. Stein" 1 => "R.P. Nelson" 2 => "J.A. Church" 3 => "R.L. Wasserman" 4 => "M. Borte" 5 => "C. Vermylen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10875-008-9231-2" "Revista" => array:6 [ "tituloSerie" => "J Clin Immunol" "fecha" => "2009" "volumen" => "29" "paginaInicial" => "137" "paginaFinal" => "144" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18814020" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparative pharmacokinetics of liquid and lyophlized formulations of IV RhUG immune globulin" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C.J. Sinclair" 1 => "W. Brooks" 2 => "M.G. Genereux" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.biologicals.2008.02.003" "Revista" => array:6 [ "tituloSerie" => "Biologicals" "fecha" => "2008" "volumen" => "36" "paginaInicial" => "256" "paginaFinal" => "262" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18406165" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intravenous immunoglobulin (endobulin) clinical tolerance: prospective therapeutic follow-up of 142 adults and children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "B. Pautard" 1 => "E. Hachulla" 2 => "M. Bagot d’Arc" 3 => "L. Chantreuil" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Med Interne" "fecha" => "2003" "volumen" => "24" "paginaInicial" => "505" "paginaFinal" => "513" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12888171" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "IgG-dimer formation in liquid immunoglobulin preparations is inhibited by nicotinamide and other amphiphilic compounds" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R. Bolli" 1 => "M.O. Spycher" 2 => "R. Brügger" 3 => "B. Wüst" 4 => "K. Gennari" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "J Autoimmun" "fecha" => "1999" "volumen" => "96" "paginaInicial" => "96" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Laboratory parameters measured during infusion of immunoglobulin preparations for intravenous use and related to tolerability" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Schnorf" 1 => "B. Arnet" 2 => "A. Burek-Kozlowska" 3 => "K. Gennari" 4 => "R. Rohner" 5 => "P.J. 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Shashi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1586/eci.11.97" "Revista" => array:6 [ "tituloSerie" => "Expert Rev Clin Immunol" "fecha" => "2012" "volumen" => "8" "paginaInicial" => "169" "paginaFinal" => "178" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22288455" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The role of proline in the prevention of aggregation during proten folding in vitro" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "T.K. Kumar" 1 => "D. Samuel" 2 => "G. Jayaraman" 3 => "T. Srimathi" 4 => "C. Yu" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Biochem Mol Biol Int" "fecha" => "1998" "volumen" => "46" "paginaInicial" => "509" "paginaFinal" => "517" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9818090" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Kiovig® Baxter Healthcare Corporation. EMEA; 2006." ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Endobulin® Baxter Healthcare Corporation. 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Darbà" 1 => "G. Restovic" 2 => "L. Kaskens" 3 => "T. de Agustín" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0091270011399575" "Revista" => array:6 [ "tituloSerie" => "J Clin Pharmacol" "fecha" => "2011" "volumen" => "52" "paginaInicial" => "566" "paginaFinal" => "575" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21593279" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Safety, efficacy and pharmacokinetics of a new 10% liquid intravenous immunoglobulin (IVIG) in patients with primary immunodeficiency" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.L. Wasserman" 1 => "J.A. Church" 2 => "M. Stein" 3 => "J. Moy" 4 => "M. White" 5 => "S. 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Original Article

J. Lozano-Blasco, M.A. Martín-Mateos

Corresponding author

martinmateos@hsjdbcn.org

Corresponding author.

, L. Alsina, O. Domínguez, M.T. Giner, M. Piquer, M. Alvaro, A.M. Plaza

Pediatric Allergy and Clinical Immunology Department of Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Barcelona, Spain

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          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Schedule of adapted ultra-slow infusion protocol&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Gammaglobulin is a standard and life-saving therapy in primary immunodeficiencies &#40;PID&#41; as well as in diseases dealing with immunoglobulin dysregulation such as neoplasia or autoimmune disorders&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The discovery&#44; 50 years ago&#44; that immunoglobulin replacement therapy decreased the susceptibility to infection in patients with PID has led to ongoing efforts to develop better&#44; safer and more comfortable formulations&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Replacement of missing IgG antibodies has been shown to reduce the frequency and severity of infections&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#8211;5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">There are currently a number of products that provide chemically unmodified lyophilised powders or liquid concentrates of polyclonal IgG&#59; these products are produced from plasma recovered from whole blood donations&#44; or more commonly from a large number of plasmapheresis donors&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Although all these intravenous immunoglobulin &#40;IVIG&#41; end products are composed of high IgG concentrations&#44; variations in manufacturing processes lead to unique product characteristics&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> In recent years&#44; new formulations with IgG concentration of 10&#37; have appeared aiming at decreasing the time of administration&#46; Indeed&#44; the rate at which IVIG can be administered can have a significant impact on patient time saving and health service use&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Likewise&#44; liquid IVIG&#44; as opposed to lyophilised products which require reconstitution&#44;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;10</span></a> are gaining support&#46; Comparative studies between liquid and lyophilised formulations of IVIG have been published&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> They concluded that liquid formulations were therapeutically equivalent and equally well tolerated to lyophilised formulations but in a more convenient ready-to-use dosage form that may also reduce preparation errors&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Despite the clear benefit of IVIGs for patients&#44; concern exists about adverse events that keep being reported&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Most of these are infusion reactions that are related to the rate of infusion&#46; When evaluating different formulations&#44;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;8&#44;12</span></a> it was found that IgG dimers were associated with infusion reactions&#44;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;13&#8211;15</span></a> and clinical tolerability of IVIG products was improved by reducing the presence of IgG dimers in IVIG formulations&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Privigen<span class="elsevierStyleSup">&#174;</span> is a 10&#37; liquid preparation of polyvalent human IgG for intravenous administration&#46; It was licensed in Europe in 2008&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> Stabilisation with <span class="elsevierStyleSmallCaps">l</span>-proline at pH 4&#46;8 is a unique feature of this formulation&#44; in that it minimises the formation of IgG dimers and preserves IgG functional activity without refrigeration&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#44;14&#44;17&#44;18</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Over the last five years&#44; our institution has been using two 10&#37; IVIG with different product characteristics&#58; Privigen<span class="elsevierStyleSup">&#174;</span> has been used from June 2009 onwards&#46; Previously a different 10&#37; IVIG was used&#44; which used glycine as a stabiliser&#46; Both are in liquid form&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> IgG levels and subclass distribution are similar in both products&#44; as well as IgA and IgM levels&#46;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19&#44;20</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">A subgroup of patients who are being followed in our outpatient clinic for primary immunodeficiencies and who are highly sensitive to previous IVIG&#44; have been treated sequentially with the two IVIG products&#46; The objective of the present study was to evaluate safety and efficacy of the 10&#37; liquid immunoglobulin preparation for intravenous use &#40;Privigen<span class="elsevierStyleSup">&#174;</span>&#41; in this particular group of paediatric patients affected with Primary Immunodeficiencies using a particular infusion protocol slower than recommended &#40;and retrospectively compare the results to a different IVIG formulation&#41;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Product</span><p id="par0040" class="elsevierStylePara elsevierViewall">Privigen<span class="elsevierStyleSup">&#174;</span> is a ready-to-use 10&#37; liquid formulation of polyvalent human IgG for intravenous administration that is stable at room temperature for its entire shelf-life&#46; The naturally occurring amphiphilic amino acid <span class="elsevierStyleSmallCaps">l</span>-proline &#40;250<span class="elsevierStyleHsp" style=""></span>mmol&#47;L<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>28&#46;8<span class="elsevierStyleHsp" style=""></span>mg&#47;mL&#41; is used as stabiliser at pH 4&#46;8&#46; Privigen<span class="elsevierStyleSup">&#174;</span> has an IgG content of 99&#46;2&#37;&#44; with more than 99&#46;8&#37; monomers and dimers &#40;dimer content is typically 6&#37;&#41;&#46; The IgG fraction from plasma is purified by a combination of cold ethanol fractionation&#44; octanoic acid precipitation and anion exchange chromatography&#46; The manufacturing process includes two dedicated viral clearance steps &#40;pH 4 incubation and nanofiltration&#41; and two partitioning steps with validated viral clearance characteristics&#46; Privigen<span class="elsevierStyleSup">&#174;</span> contains no preservative&#44; has a low sodium content &#40;&#8804;1<span class="elsevierStyleHsp" style=""></span>mmol&#47;L&#41; and osmolality &#40;320<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9<span class="elsevierStyleHsp" style=""></span>mOsm&#47;kg&#41; is in the physiological range&#46; Only trace amounts of IgA are present &#40;8&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;8<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;mL&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">The previous IVIG used was also a 10&#37; liquid form&#44; but glycine was used as stabiliser instead&#46; The maximum IgA content was 140<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;ml and the IgG content was at least of 98&#37;&#46; It required be stored in a refrigerator &#40;2&#8211;8<span class="elsevierStyleHsp" style=""></span>&#176;C&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Patients</span><p id="par0050" class="elsevierStylePara elsevierViewall">The present work was undertaken in the Paediatric Allergy and Clinical Immunology Department of Hospital Sant Joan de D&#233;u&#44; a Tertiary-level Multi-speciality Mother and Child Hospital&#46; Eight patients were included &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; They had a diagnosis of Primary Immune Deficiency&#44; according to the International Union of Immunological Societies Expert Committee classification <a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&#58; Common Variable Immunodeficiency &#40;CVID&#41; &#40;four patients&#41;&#44; and other humoral deficiencies &#40;four patients&#41;&#46; All of them had been switched from the previous 10&#37; IVIG formulation to Privigen<span class="elsevierStyleSup">&#174;</span> in an open protocol due to severe and&#47;or recurrent adverse events&#44; despite premedication and reduction of infusion rate&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Study design</span><p id="par0055" class="elsevierStylePara elsevierViewall">Data were prospectively collected regarding Privigen<span class="elsevierStyleSup">&#174;</span> administration&#58; infusion &#40;dose&#44; rate&#44; total time&#44; and interval&#41;&#44; safety &#40;interview with parents and patients about adverse events during the infusion and&#44; by telephone&#44; 72<span class="elsevierStyleHsp" style=""></span>h later&#59; use of premedication or rescue medication&#41; and efficacy &#40;measurement of trough levels before first administration and after three doses of Privigen<span class="elsevierStyleSup">&#174;</span>&#59; clinical efficacy was assessed by questionnaire and chart review &#8211; use of antibiotics and severe infections while under Privigen<span class="elsevierStyleSup">&#174;</span>&#41;&#46; In parallel&#44; data on safety and tolerance were retrospectively collected from medical charts regarding the previous 10&#37; IVIG product used&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Administration protocol</span><p id="par0060" class="elsevierStylePara elsevierViewall">The infusion rate used for this particularly susceptible group of patients was lower than the recommended by the manufacturer &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#58; in the first administration&#44; the initial rate was 0&#46;16<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;min &#40;instead of the recommended 0&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;min&#41;&#46; The rate was increased 60<span class="elsevierStyleHsp" style=""></span>min later to 0&#46;33<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;min if no reaction been observed&#44; and was kept for 60<span class="elsevierStyleHsp" style=""></span>min&#46; Then an increase to 0&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;min&#44; 1 and 2<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;min in 30<span class="elsevierStyleHsp" style=""></span>min intervals&#44; followed&#44; if tolerated&#46; If no reaction was observed 72<span class="elsevierStyleHsp" style=""></span>h after administration&#44; the second infusion was started at 0&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;min&#44; and increased to 1 and 2<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;min &#40;maximum rate&#41; every 60<span class="elsevierStyleHsp" style=""></span>min&#46; The third and fourth infusions were started at 0&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;min&#44; which were doubled every 60<span class="elsevierStyleHsp" style=""></span>min to a maximum of 4<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;min and 8<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;min&#44; respectively&#46; After the fifth infusion&#44; the rates were increased every 30<span class="elsevierStyleHsp" style=""></span>min&#44; if tolerated&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Premedication use</span><p id="par0065" class="elsevierStylePara elsevierViewall">The patients who were routinely given premedication with the previous 10&#37; IVIG&#44; were given the same premedication with the first dose of Privigen<span class="elsevierStyleSup">&#174;</span>&#46; Premedication was stopped if Privigen<span class="elsevierStyleSup">&#174;</span> was well tolerated&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Results</span><p id="par0070" class="elsevierStylePara elsevierViewall">Eight patients with humoral PID &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41; were followed for a minimum of six months under Privigen<span class="elsevierStyleSup">&#174;</span>&#46; Median age was 11 years old &#40;3&#46;5&#8211;17&#46;9 years&#41;&#44; and 75&#37; were male&#46; Four patients carried a diagnosis of CVID&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">All patients had previously been under IVIG treatment with another 10&#37; liquid formulation for a minimum of one year and a maximum of three years&#46; A median of 23&#46;6 doses per patient had been administered &#40;range&#58; 14&#8211;34<span class="elsevierStyleHsp" style=""></span>doses&#47;patient&#41;&#46; IVIG replacement dose was 475<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;dose &#40;range 300&#8211;600<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;dose&#41;&#44; every four weeks for all patients except one &#40;every three weeks&#41;&#46; All patients had suffered adverse events during IVIG infusion &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#44; being severe in three patients &#40;seizures&#44; severe headache and anaphylactic-like reactions&#41;&#44; and recurrent in the rest &#40;headache&#44; vomits&#44; cough&#41;&#46; In five patients &#40;62&#46;5&#37;&#41; adverse events also occurred 24&#8211;48<span class="elsevierStyleHsp" style=""></span>h after infusion&#44; and included headache &#40;three patients&#41;&#44; pyrexia &#40;two patients&#41;&#44; general aches &#40;one patient&#41; and abdominal pain &#40;one patient&#41;&#46; 50&#37; of the patients received premedication systematically&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">All patients were switched to Privigen<span class="elsevierStyleSup">&#174;</span> in an open protocol due to severe or repeated adverse events related to IVIG infusion&#46; The same dose and interval were used with the two different formulations&#46; Premedication was given before the first Privigen<span class="elsevierStyleSup">&#174;</span> infusion to those patients that were receiving it with the previous IVIG&#46; After the second infusion&#44; this premedication could be withdrawn in all patients&#46; A median of 6&#46;6 doses per patient &#40;range 5&#8211;9 doses&#47;patient&#41; was administered during the follow up&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Adverse events were registered in three patients &#40;37&#46;5&#37;&#41;&#58; two patients during the first Privigen<span class="elsevierStyleSup">&#174;</span> infusion &#40;pyrexia and headache&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; In all cases&#44; symptoms were mild and were controlled with the use of acetaminophen and dexchlorpheniramine&#44; and they ceased in subsequent infusions&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Two other patients had reactions 24&#8211;48<span class="elsevierStyleHsp" style=""></span>h after the infusion&#46; One referred a mild headache that resolved in 30<span class="elsevierStyleHsp" style=""></span>min without medication&#46; The other referred fatigue for 24<span class="elsevierStyleHsp" style=""></span>h&#44; but was able to perform regular activity&#46; She had had serious adverse events under the previous IVIG&#46; In summary&#44; all reactions &#40;during and or after Privigen<span class="elsevierStyleSup">&#174;</span>&#41; were mild and did not need premedication&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">At the end of the study&#44; the median time of administration was 3&#46;3<span class="elsevierStyleHsp" style=""></span>h&#47;dose&#47;patient &#40;range 2&#46;5&#8211;4<span class="elsevierStyleHsp" style=""></span>h&#47;dose&#47;patient&#41;&#44; with a median infusion dose of 6&#46;4<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;min &#40;range of 3&#46;3&#8211;8<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;min&#41;&#44; shorter than that to previous IVIG&#46; No patient was in need of premedication&#46; Five patients reached the maximum recommended dose of 8<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;min&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">During the six-month-follow-up on Privigen<span class="elsevierStyleSup">&#174;</span>&#44; no patient developed a severe infection requiring hospitalisation&#46; No antibiotics were needed to treat mild infections&#46; Median IgG trough levels after the third dose of Privigen<span class="elsevierStyleSup">&#174;</span> were similar to those reached with the previous IVIG &#40;median IgG 7700<span class="elsevierStyleHsp" style=""></span>mg&#47;L and 7400<span class="elsevierStyleHsp" style=""></span>mg&#47;L&#44; respectively&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#44; with the same dose being administered for both products&#46; In all patients&#44; trough levels were above 5500<span class="elsevierStyleHsp" style=""></span>mg&#47;L&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0105" class="elsevierStylePara elsevierViewall">This study confirmed both safety and efficacy of Privigen<span class="elsevierStyleSup">&#174;</span> for paediatric use in PID&#46; Also&#44; to our understanding&#44; this is the first study to evaluate the use of Privigen<span class="elsevierStyleSup">&#174;</span> in a subgroup of paediatric PID patients who are highly sensitive &#40;that do not tolerate previous IVIG infusions&#41;&#46; We show that Privigen<span class="elsevierStyleSup">&#174;</span> is suitable for these patients with low tolerance to other IVIG products&#46; Furthermore&#44; this product would also be convenient as a starting replacement therapy&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Most patients included in the study were diagnosed of CVID&#46; This is in accordance with a recent survey by the Immune Deficiency Foundation which indicated that patients with CVID and agammaglobulinaemia represent approximately 77&#37; of PID patients currently receiving IVIG replacement therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> Doses and administration intervals were also as per current practice&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">In this work we have devised an open and adapted infusion protocol for this especially sensitive group of patients to IVIG products&#58; the infusion rate was slower than recommended by the manufacturer&#46; This protocol was effective&#58; indeed&#44; all patients suffered only from very mild adverse reactions&#44; none needed premedication&#44; and in five patients&#44; the maximum infusion rate recommended by the manufacturer &#40;8<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;min&#41; could be reached&#46; Median time needed to administer Privigen<span class="elsevierStyleSup">&#174;</span> doses was 3&#46;3<span class="elsevierStyleHsp" style=""></span>h &#40;range 2&#46;5&#8211;4<span class="elsevierStyleHsp" style=""></span>h&#47;dose&#47;patient&#41;&#44; which was significantly reduced compared to the previous IVIG&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> This reduction in the time of administration was particularly appreciated by patients and parents to decrease school and work absenteeism&#44; respectively&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">The number of patients suffering adverse events during Privigen<span class="elsevierStyleSup">&#174;</span> &#40;11&#46;3&#37;&#41;&#44; was not only reduced compared to the previous 10&#37; IVIG&#44; but also compared to what is published related to Privigen<span class="elsevierStyleSup">&#174;</span> &#40;21&#37;&#41; <a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;10&#44;24</span></a> and other IVIG products &#40;24&#46;9&#37; and 29&#46;1&#37;&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">25&#44;26</span></a> despite reaching maximum infusion rates&#46; Besides&#44; the reactions referred were all mild &#40;low pyrexia&#44; headache&#41;&#44; compared to the severe reactions the same patients had had with the previous IVIG&#44; that were all limiting to their daily lives&#46; These reactions all disappeared in the following injections&#44; as expected&#44;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> and no patient needed premedication after the second Privigen<span class="elsevierStyleSup">&#174;</span> infusion&#46; The most frequent adverse event was headache&#44; as published with Privigen<span class="elsevierStyleSup">&#174;</span> in another group of patients <a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> and with other IVIG products&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">25&#44;26</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">This study has a clear limitation in that the retrospective data obtained from the previous 10&#37; IVIG product cannot be directly compared to the prospective data collected for Privigen<span class="elsevierStyleSup">&#174;</span>&#46; Besides&#44; the protocol is open and not double blinded&#46; Despite these limitations&#44; this adapted infusion protocol with Privigen<span class="elsevierStyleSup">&#174;</span> shows a clear tendency towards a safer profile compared to the previous IVIG&#44; at least in these first six months of follow-up&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">As for efficacy&#44; it is general consensus that IgG trough levels should be above 5000<span class="elsevierStyleHsp" style=""></span>mg&#47;L&#44;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;28&#8211;30</span></a> as is observed in all of our patients&#44; after using a standard infusion dose of 400&#8211;600<span class="elsevierStyleHsp" style=""></span>mg&#47;kg every 3&#8211;4 weeks&#46; These trough levels were even slightly higher compared to the previous IVIG&#44; using the same replacement dose and interval &#40;median trough IgG 7700<span class="elsevierStyleHsp" style=""></span>mg&#47;L and 7400<span class="elsevierStyleHsp" style=""></span>mg&#47;L&#44; for Privigen<span class="elsevierStyleSup">&#174;</span> and previous IVIG&#44; respectively&#41;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conclusions</span><p id="par0135" class="elsevierStylePara elsevierViewall">The present work shows that this novel 10&#37; liquid IVIG was safe in a special group of paediatric patients who did not tolerate the administration of a previous 10&#37; liquid IVIG&#46; The number of adverse effects was smaller than published&#44; and all cases were mild&#46; No premedication was needed&#46; Privigen<span class="elsevierStyleSup">&#174;</span> was also effective in this small group&#44; with IgG trough levels being stable and in the higher range&#44; along with no infections clinically&#46; The combination of well-tolerated high infusion rates and convenience of use due to liquid presentation and room temperature storage would be potentially advantageous for both patients and healthcare personnel&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Ethical disclosures</span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Protection of human and animal subjects</span><p id="par0140" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this investigation&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Confidentiality of data</span><p id="par0145" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Right to privacy and informed consent</span><p id="par0150" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appears in this article&#46;</p></span></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflict of interest</span><p id="par0155" class="elsevierStylePara elsevierViewall">The authors have no conflict of interest to declare&#46;</p></span></span>"
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              "identificador" => "sec0065"
              "titulo" => "Confidentiality of data"
            ]
            2 => array:2 [
              "identificador" => "sec0070"
              "titulo" => "Right to privacy and informed consent"
            ]
          ]
        ]
        8 => array:2 [
          "identificador" => "sec0075"
          "titulo" => "Conflict of interest"
        ]
        9 => array:2 [
          "identificador" => "xack77071"
          "titulo" => "Acknowledgement"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2012-07-31"
    "fechaAceptado" => "2012-10-26"
    "PalabrasClave" => array:1 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec307259"
          "palabras" => array:5 [
            0 => "Adverse events"
            1 => "Efficacy"
            2 => "Intravenous immunoglobulin"
            3 => "Paediatrics"
            4 => "Primary immunodeficiency"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:1 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The objective of this study was to evaluate safety and efficacy of Privigen<span class="elsevierStyleSup">&#174;</span>&#44; a 10&#37; intravenous immunoglobulin &#40;IVIG&#41;&#44; in a particular group of paediatric patients &#40;highly sensitive to previous IVIG infusion&#41; affected with Primary Immunodeficiencies &#40;PID&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Patients &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#41; from 3 to 17 years old diagnosed of PID who often suffered from adverse events related to the infusion to previous IVIG were switched to Privigen<span class="elsevierStyleSup">&#174;</span> in an open protocol&#46; Data were prospectively collected regarding Privigen<span class="elsevierStyleSup">&#174;</span> administration&#58; infusion&#44; safety and efficacy&#46; In parallel&#44; data on safety and tolerance were retrospectively collected from medical charts regarding the previous 10&#37; IVIG product used&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">50&#37; of the patients required premedication with previous IVIG&#46; At the end of the study none required premedication with Privigen<span class="elsevierStyleSup">&#174;</span>&#46; The infusion rate was lower than that recommended by the manufacturer&#46; All patients had suffered through adverse events during previous IVIG infusion being severe in three patients and recurrent in the rest&#46; With Privigen<span class="elsevierStyleSup">&#174;</span> only three patients suffered from an adverse event &#40;all cases were milder than previous related&#41;&#46; Trough levels of IgG remained stable&#46; None suffer from any episode of bacterial infection&#46;</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The present work shows that Privigen<span class="elsevierStyleSup">&#174;</span> was safe in a group of hypersensitive paediatric patients who did not tolerate the administration of a previous 10&#37; liquid IVIG by using a particular infusion protocol slower than recommended&#46; The number of adverse effects was smaller than published&#44; and all cases were mild&#46; No premedication was needed&#46; Privigen<span class="elsevierStyleSup">&#174;</span> was also effective in this small group&#46;</p>"
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1909
            "Ancho" => 1583
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Schedule of adapted ultra-slow infusion protocol&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Patient&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Age &#40;year&#44; months&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Gender&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Diagnosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Ethnicity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Weight &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#9792;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CVID&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caucasian&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#9794;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CVID&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caucasian&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#9794;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Impaired polysaccharide responsiveness&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caucasian&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#9794;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hyper IgM Syndrome&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caucasian&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#46;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#9792;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CVID&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caucasian&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#9794;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Agammaglobulinaemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caucasian&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#9794;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Transient hypogammaglobulinaemia of infancy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caucasian&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#9794;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CVID&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caucasian&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Summary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Median age&#58; 11 year and 1 month&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">75&#37; &#9794;25&#37; &#9792;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 patients&#58; CVID4 patients&#58; other humoral deficiencies&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#37; Caucasian&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Median weight&#58; 36&#46;75<span class="elsevierStyleHsp" style=""></span>kg&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab474711.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Demographic patient characteristics&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Privigen<span class="elsevierStyleSup">&#174;</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Previous IVIG</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">AE<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> during infusion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">AE<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> after infusion to 72<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Premedication&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">AE<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> during infusion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">AE<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> after infusion to 72<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Premedication&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cough&#44; pyrexia and headache<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fatigue<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Headache&#44; sweating&#44; abdominal pain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mild headache<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Headache&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pyrexia<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Chills&#44; pyrexia and general aches&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cough and vomits&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Seizures&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cough and itchy throat&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pyrexia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Headache&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab474713.png"
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          "notaPie" => array:2 [
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            1 => array:3 [
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            ]
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        "descripcion" => array:1 [
          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Summary of adverse events&#46;</p>"
        ]
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      3 => array:7 [
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        "tabla" => array:2 [
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
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                            1 => "F&#46;P&#46; Siegal"
                            2 => "E&#46;M&#46; Smithwick"
                            3 => "A&#46; Lion-Boul&#233;"
                            4 => "S&#46; Cunningham-Rundles"
                            5 => "J&#46; O&#8217;Malley"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "1984"
                        "volumen" => "101"
                        "paginaInicial" => "435"
                        "paginaFinal" => "439"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6206756"
                            "web" => "Medline"
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                ]
              ]
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            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Primary Immunodeficiency Committee of the American Academy of Allergy&#44; Asthma and Immunology&#46; Use of intravenous immunoglobulin in human disease&#58; a review of evidence by members of the Primary Immunodeficiency Committee of the American Academy of Allergy&#44; Asthma and Immunology"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;S&#46; Orange"
                            1 => "E&#46;M&#46; Hossny"
                            2 => "C&#46;R&#46; Weiler"
                            3 => "M&#46; Ballow"
                            4 => "M&#46; Berger"
                            5 => "F&#46;A&#46; Bonilla"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "2006"
                        "volumen" => "117"
                        "paginaInicial" => "525"
                        "paginaFinal" => "552"
                      ]
                    ]
                  ]
                ]
              ]
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            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A newer immunoglobulin intravenous &#40;IGIV&#41; &#8211; Gammard liquid 10&#37;&#58; evaluation of efficacy&#44; safety&#44; tolerability and impact on patient care"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46;R&#46; Shah"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1517/14712598.8.6.799"
                      "Revista" => array:6 [
                        "tituloSerie" => "Expert Opin Biol Ther"
                        "fecha" => "2008"
                        "volumen" => "8"
                        "paginaInicial" => "799"
                        "paginaFinal" => "804"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18476791"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tolerability of a new 10&#37; liquid immunoglobulin for intravenous use&#44; Privigen<span class="elsevierStyleSup">&#174;</span>&#44; at different infusion rates"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;W&#46; Sleasman"
                            1 => "C&#46;M&#46; Duff"
                            2 => "T&#46; Dunaway"
                            3 => "M&#46;A&#46; Rojavin"
                            4 => "M&#46;R&#46; Stein"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10875-010-9373-x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Immunol"
                        "fecha" => "2010"
                        "volumen" => "30"
                        "paginaInicial" => "442"
                        "paginaFinal" => "448"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20217199"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "<span class="elsevierStyleSmallCaps">l</span>-Proline-stabilized human IgG&#58; Privigen<span class="elsevierStyleSup">&#174;</span> 10&#37; for intravenous use and Hizentra<span class="elsevierStyleSup">&#174;</span> 20&#37; for subcutaneous use"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46; Berger"
                          ]
                        ]
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                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2217/imt.10.108"
                      "Revista" => array:6 [
                        "tituloSerie" => "Immunotherapy"
                        "fecha" => "2011"
                        "volumen" => "3"
                        "paginaInicial" => "163"
                        "paginaFinal" => "176"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21322757"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "IgPro10 in PID study group&#58; safety and efficacy of Privigen&#44; a novel 10&#37; liquid immunoglobulin preparation for intravenous use&#44; in patients with primary immunodeficiencies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;R&#46; Stein"
                            1 => "R&#46;P&#46; Nelson"
                            2 => "J&#46;A&#46; Church"
                            3 => "R&#46;L&#46; Wasserman"
                            4 => "M&#46; Borte"
                            5 => "C&#46; Vermylen"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10875-008-9231-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Immunol"
                        "fecha" => "2009"
                        "volumen" => "29"
                        "paginaInicial" => "137"
                        "paginaFinal" => "144"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18814020"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparative pharmacokinetics of liquid and lyophlized formulations of IV RhUG immune globulin"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46;J&#46; Sinclair"
                            1 => "W&#46; Brooks"
                            2 => "M&#46;G&#46; Genereux"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.biologicals.2008.02.003"
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                        "tituloSerie" => "Biologicals"
                        "fecha" => "2008"
                        "volumen" => "36"
                        "paginaInicial" => "256"
                        "paginaFinal" => "262"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18406165"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intravenous immunoglobulin &#40;endobulin&#41; clinical tolerance&#58; prospective therapeutic follow-up of 142 adults and children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "B&#46; Pautard"
                            1 => "E&#46; Hachulla"
                            2 => "M&#46; Bagot d&#8217;Arc"
                            3 => "L&#46; Chantreuil"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Med Interne"
                        "fecha" => "2003"
                        "volumen" => "24"
                        "paginaInicial" => "505"
                        "paginaFinal" => "513"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12888171"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "IgG-dimer formation in liquid immunoglobulin preparations is inhibited by nicotinamide and other amphiphilic compounds"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46; Bolli"
                            1 => "M&#46;O&#46; Spycher"
                            2 => "R&#46; Br&#252;gger"
                            3 => "B&#46; W&#252;st"
                            4 => "K&#46; Gennari"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "J Autoimmun"
                        "fecha" => "1999"
                        "volumen" => "96"
                        "paginaInicial" => "96"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Laboratory parameters measured during infusion of immunoglobulin preparations for intravenous use and related to tolerability"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Schnorf"
                            1 => "B&#46; Arnet"
                            2 => "A&#46; Burek-Kozlowska"
                            3 => "K&#46; Gennari"
                            4 => "R&#46; Rohner"
                            5 => "P&#46;J&#46; Spath"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Intravenous immunoglobulin research and therapy"
                        "paginaInicial" => "312"
                        "paginaFinal" => "313"
                        "serieFecha" => "1996"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Well-tolerated liquid intravenous immunoglobulin G preparations &#40;IVIG&#41; have a low immunoglobulin G dimer &#40;IgGdimer&#41; content"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46;O&#46; Spycher"
                            1 => "R&#46; Bolli"
                            2 => "G&#46; Hodler"
                            3 => "K&#46; Gennari"
                            4 => "A&#46; Hubsch"
                            5 => "P&#46; Sp&#228;th"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "J Autoimmun"
                        "fecha" => "1999"
                        "numero" => "Suppl&#46; 1"
                        "paginaInicial" => "96"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Privigen<span class="elsevierStyleSup">&#174;</span> CSL Behring&#46; EMEA&#59; 2008&#46;"
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              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Safety of <span class="elsevierStyleSmallCaps">l</span>-proline as a stabilizer for immunoglobulin products"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;B&#46; Hagan"
                            1 => "R&#46;L&#46; Wasserman"
                            2 => "J&#46;S&#46; Baggish"
                            3 => "M&#46;O&#46; Spycher"
                            4 => "M&#46; Berger"
                            5 => "V&#46; Shashi"
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                        ]
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                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1586/eci.11.97"
                      "Revista" => array:6 [
                        "tituloSerie" => "Expert Rev Clin Immunol"
                        "fecha" => "2012"
                        "volumen" => "8"
                        "paginaInicial" => "169"
                        "paginaFinal" => "178"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22288455"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The role of proline in the prevention of aggregation during proten folding in vitro"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "T&#46;K&#46; Kumar"
                            1 => "D&#46; Samuel"
                            2 => "G&#46; Jayaraman"
                            3 => "T&#46; Srimathi"
                            4 => "C&#46; Yu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Biochem Mol Biol Int"
                        "fecha" => "1998"
                        "volumen" => "46"
                        "paginaInicial" => "509"
                        "paginaFinal" => "517"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9818090"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
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              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Kiovig<span class="elsevierStyleSup">&#174;</span> Baxter Healthcare Corporation&#46; EMEA&#59; 2006&#46;"
                ]
              ]
            ]
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              "identificador" => "bib0100"
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              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Endobulin<span class="elsevierStyleSup">&#174;</span> Baxter Healthcare Corporation&#46; Agencia Espa&#241;ola de Medicamentos y productos Sanitarios&#59; 2002&#46;"
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              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Classification of primary immunodeficiency diseases by the International Union of Immunological Societies &#40;IUIS&#41; Expert Committee on Primary Immunodeficiency 2011"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2249.2012.04561.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Immunol"
                        "fecha" => "2012"
                        "volumen" => "168"
                        "paginaInicial" => "58"
                        "paginaFinal" => "59"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22385238"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "titulo" => "Treatment experiences and preferences of patient with primary immune deficiency diseases"
                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:2 [
                        "titulo" => "Survey results presented at the immune deficiency foundation meeting&#44; 20 June"
                        "serieFecha" => "2003"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Direct medical costs of liquid intravenous immunoglobulins in children&#44; adolescents&#44; and adults in Spain"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
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                            1 => "G&#46; Restovic"
                            2 => "L&#46; Kaskens"
                            3 => "T&#46; de Agust&#237;n"
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                        ]
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                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/0091270011399575"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Pharmacol"
                        "fecha" => "2011"
                        "volumen" => "52"
                        "paginaInicial" => "566"
                        "paginaFinal" => "575"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21593279"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0120"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Safety&#44; efficacy and pharmacokinetics of a new 10&#37; liquid intravenous immunoglobulin &#40;IVIG&#41; in patients with primary immunodeficiency"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            1 => "J&#46;A&#46; Church"
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                            3 => "J&#46; Moy"
                            4 => "M&#46; White"
                            5 => "S&#46; Strausbaugh"
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                        ]
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                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10875-012-9656-5"
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                        "tituloSerie" => "J Clin Immunol"
                        "fecha" => "2012"
                        "volumen" => "32"
                        "paginaInicial" => "663"
                        "paginaFinal" => "669"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22392046"
                            "web" => "Medline"
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                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prescribing Information"
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                          "etal" => false
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                            0 => "Flebogamma&#174; 5&#37;"
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                        "editorial" => "Grifols S&#46;A&#46;"
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                ]
              ]
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              "identificador" => "bib0130"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "titulo" => "Gammagard<span class="elsevierStyleSup">&#174;</span> liquid summary basis of approval"
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                    0 => array:1 [
                      "Libro" => array:2 [
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                        "editorial" => "Baxter Healthcare Corporation"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prospective audit of adverse reactions occurring in 459 primary antibody-deficient patients receiving intravenous immunoglobulin"
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                          "etal" => false
                          "autores" => array:3 [
                            0 => "V&#46;M&#46; Brennan"
                            1 => "N&#46;J&#46; Salome-Bentley"
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                        ]
                      ]
                    ]
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                        "link" => array:1 [
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                      "titulo" => "Inter-University Working Party for the Study of Immune Deficiencies&#58; the effect of two different dosages of intravenous immunoglobulin on the incidence of recurrent infections in patients with primary hypogammaglobulinemia&#46; A randomized&#44; double-blind&#44; multicenter crossover trial"
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                        "tituloSerie" => "Ann Intern Med"
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                        "paginaInicial" => "165"
                        "paginaFinal" => "174"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11487483"
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                        "tituloSerie" => "Lancet"
                        "fecha" => "1987"
                        "volumen" => "1"
                        "paginaInicial" => "1075"
                        "paginaFinal" => "1077"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2566020"
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                      ]
                    ]
                  ]
                ]
              ]
            ]
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                      "titulo" => "Human intravenous immunoglobulin in primary and secondary antibody deficiencies"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "E&#46;R&#46; Stiehm"
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                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Infect Dis J"
                        "fecha" => "1997"
                        "volumen" => "16"
                        "paginaInicial" => "696"
                        "paginaFinal" => "707"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9239774"
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Article information

ISSN: 03010546
Original language: English

DOI:10.1016/j.aller.2012.10.006

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Year/Month	Html	Pdf	Total

2024 November	3	0	3
2024 October	48	9	57
2024 September	73	14	87
2024 August	51	26	77
2024 July	36	11	47
2024 June	43	11	54
2024 May	50	12	62
2024 April	53	8	61
2024 March	78	11	89
2024 February	106	18	124
2024 January	507	5	512
2023 December	116	15	131
2023 November	154	13	167
2023 October	170	13	183
2023 September	59	8	67
2023 August	75	6	81
2023 July	135	11	146
2023 June	120	7	127
2023 May	184	9	193
2023 April	135	20	155
2023 March	151	12	163
2023 February	132	14	146
2023 January	110	14	124
2022 December	70	8	78
2022 November	83	19	102
2022 October	75	16	91
2022 September	93	15	108
2022 August	114	19	133
2022 July	65	22	87
2022 June	62	20	82
2022 May	76	34	110
2022 April	90	38	128
2022 March	67	29	96
2022 February	102	40	142
2022 January	145	18	163
2021 December	65	32	97
2021 November	68	31	99
2021 October	88	28	116
2021 September	104	22	126
2021 August	94	14	108
2021 July	103	16	119
2021 June	55	27	82
2021 May	43	28	71
2021 April	119	44	163
2021 March	58	43	101
2021 February	70	29	99
2021 January	26	13	39
2020 December	2	6	8
2020 November	0	4	4
2020 October	0	4	4
2020 September	0	4	4
2020 August	0	1	1
2020 July	0	2	2
2020 June	0	1	1
2020 May	0	2	2
2020 April	0	1	1
2020 March	0	1	1
2020 February	0	1	1
2020 January	0	3	3
2019 December	0	6	6
2019 November	0	2	2
2019 October	0	4	4
2019 September	0	2	2
2019 July	0	3	3
2019 June	0	1	1
2019 May	0	18	18
2018 March	1	0	1
2018 February	14	0	14
2018 January	15	3	18
2017 December	8	1	9
2017 November	17	1	18
2017 October	21	3	24
2017 September	17	0	17
2017 August	19	3	22
2017 July	27	2	29
2017 June	26	4	30
2017 May	41	15	56
2017 April	20	5	25
2017 March	10	8	18
2017 February	24	6	30
2017 January	16	1	17
2016 December	21	5	26
2016 November	29	8	37
2016 October	39	7	46
2016 September	34	11	45
2016 August	19	13	32
2016 July	21	7	28
2016 June	23	14	37
2016 May	14	13	27
2016 April	18	14	32
2016 March	26	20	46
2016 February	23	21	44
2016 January	17	17	34
2015 December	14	17	31
2015 November	13	14	27
2015 October	18	11	29
2015 September	18	7	25
2015 August	13	5	18
2015 July	7	6	13
2015 June	8	4	12
2015 May	5	5	10
2015 April	12	11	23
2015 March	15	3	18
2015 February	2	4	6
2014 December	0	1	1
2014 November	1	1	2
2014 October	2	5	7
2014 August	0	1	1
2014 July	1	1	2
2014 June	2	1	3
2014 May	5	5	10
2014 April	1	9	10

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Allergologia et Immunopathologia is no longer published on Elsevier since the 2021 year.Transferred to Codon Publications

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Allergologia et Immunopathologia is no longer published on Elsevier since the 2021 year.Transferred to Codon Publications

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