Throughout our website and across our social media, Inflammatory Neuropathies UK will often highlight the importance of plasma in the creation of treatments like IVIg, and SCIg. The following is a clear and accessible overview of plasma, and these treatments. We also take a look at pregnancy and immunoglobulin treatment. 

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 Plasma 

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Plasma is the liquid part of your blood. 

 

Your blood is comprised of approximately:

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• 55% liquid plasma

• 44% red blood cells

• 1% white blood cells and platelets

 

Plasma carries blood cells, proteins, nutrients, and salts throughout your body. It also carries waste products to your kidneys and liver. 

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Among the proteins in plasma are antibodies. These recognise and fight infections such as viruses and bacteria. They are a vital part of your immune system. 

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However, in Inflammatory Neuropathies, these antibodies can go wrong. Instead of protecting you and fighting off infections, they mistakenly recognise your nerves as a threat and launch an attack.

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One of the most effective ways to interrupt or halt the harmful immune response is to "overwhelm" the faulty antibodies with healthy ones. This is what happens in IVIg and SCIg.

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 Immunoglobulin - IVIg and Scig 

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IVIg stands for Intravenous Immunoglobulin, and SCIg stands for Subcutaneous Immunoglobulin. Both are treatments made from donated human plasma. 

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People can donate plasma directly at a limited number of centres across the UK, but it is also taken as part of a routine blood donation (remember, 55% of your blood is plasma). 

This yellow-ish liquid is separated from the other blood components and goes to specialist where it is processed into immunoglobulin. The process is called Fractionation.

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This can then be administered as IVIg or SCIg.

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IVIg

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Someone receiving IVIg treatment visits a hospital or clinic that can perform the procedure. 

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A drip is then inserted into their vein (Intravenous) and over the course of several hours, their body will be flooded by a healthy supply of antibodies. 

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SCIg

 

Instead of being delivered into a vein through a drip, SCIg is given into the fatty tissue just under the skin (the “subcutaneous” layer). This is usually done at home using a small portable pump and fine needles by the patient or a carer.

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For people living with a chronic condition like CIDP or MMN, SCIg can offer several potential benefits like greater independence and less hospital visits. However, it is not always suitable for everyone for various reasons - including suitability, cost, training, and availability.

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 How often and how much? 

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Treatment varies depending on the condition. 

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In acute conditions like Guillain–Barré Syndrome (GBS), IVIg may be given just once or twice. The sheer volume of IVIg reduces the inflammation, interrupts the immune attack, and the recovery process can now begin. 

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In the case of chronic conditions like CIDP or MMN, the attack is temporarily calmed. Because the condition is ongoing, treatment needs to be repeated regularly.

 

Your care team will work out the frequency and dose that is right for you.

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Over time, this may be fine-tuned and adjusted to help you achieve the best possible quality of life. 

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 When should I receive treatment? 

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It can help to picture a child's drawing of the sea. There's waves that go up and down sharply in dips and spikes.

 

• 'dips' - the bottom of the wave: minimal symptoms

• 'spikes' - the top of the wave: symptoms worsening.

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The first time you receive treatment, you'll likely be in a spike phase. The treatment works to bring you down into a dip where symptoms are calmer and independence is, hopefully, restored.

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Over time - often 2–5 weeks, though this varies - symptoms may gradually begin to return as you move toward another spike.

 

Receiving treatment early, as symptoms begin to reappear, is generally more effective than waiting until they are fully established.

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In an ideal world, treatment timing would smooth those peaks and troughs into a steady, balanced line. In reality, that isn’t always possible — but careful planning between you and your care team can help reduce the severity of those waves as much as possible.

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 Long term IVIg ​

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Repeated IV access can impact your veins, particularly if you're receiving treatment frequently for a long time. Over time, some (but not all) may find their veins become harder to find, or narrow and scar. You might find you bruise more easily, or experience a little discomfort during the procedure.

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To avoid this, your infusion team will likely rotate vein sites so they're not overwhelming the same spot. Good infusion practice will help keep your veins as healthy as possible.

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If you're finding your infusion sites get irritated, your team may slow down infusion rates to lessen the stress in that area.​

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In some rare cases, they may look at inserting something called a long-term venous access device such as a port.

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If your veins really are responding negatively to the treatment, they may also look at switching you to a different treatment including SCIg.

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 IVIg/SCIg and Pregnancy 

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Immunoglobulin is made from human plasma and contains natural antibodies. It does not contain a live virus and is not a drug in the traditional sense, it is a purified blood product. 

 

Because it works by regulating the immune system rather than suppressing it, it is generally regarded as being safe to continue/receive during pregnancy. In fact, it has been used safely in pregnancy for many years not just in neurological conditions, but obstetrics and immunology. 

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If you're receiving SCIg into your abdomen, some practical adjustments may be needed - such as alternative infusion sites. 

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If you're already pregnant, your neurology and maternity teams will work closely together for the safety of you and your unborn child. 

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If you are not yet pregnant, but plan to start a family, speak to your neurologist early to allow for planning and any required adjustments.

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Will my baby be impacted?

 

While Immunoglobulin does cross the placenta in late pregnancy, this is a normal and healthy process. All mothers pass antibodies to their babies to help protect them in the first few months of life.

 

There is no evidence that IVIg or SCIg causes harm to the developing baby when prescribed appropriately.

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Breastfeeding

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As antibodies are naturally present in breast milk, breastfeeding is also usually considered compatible with immunoglobulin treatment,