A retrospective medical record review was performed for patients enrolled in this organization’s IAE clinical program from 10/01/2022-05/31/2023, including medical history, triggering events, IAE symptoms, and pharmacy dispensing history.

Forty-seven IAE patients received IG therapy within the study period (66% male). The average age of diagnosis was 20 years old.

Sixty-eight triggering events identified included infections, stress, tick bites without confirmed infection, and primary immunodeficiency. Fifteen patients had unknown triggers.

Patients sought care from an average of 4 different specialists (range 1-12), most frequently neurology, psychiatry, infectious disease, pediatrics, allergy/immunology, and neuroimmunology.

Symptoms reported included psychiatric symptoms 74%, obsessive-compulsive behaviors 70%, cognitive deficits 64%, tics/involuntary movements 60%, autonomic irregularities 43%, headaches/migraines 43%, sensory perception issues 40%, separation anxiety 38%, and loss in motor skills 21%.

Forty-four patients received intravenous IG therapy. Average dosing was 1.6 g/kg with frequencies of every 4 weeks (68%), one-time orders (13%), and every 8 weeks (9%). Three patients received subcutaneous IG at an average of 63.33 grams monthly (1.6 g/kg) divided into weekly or biweekly doses. Most patients (53%) were IG-naïve at the time of referral to this complex specialty pharmacy.

IAE is a complex condition requiring multidisciplinary support. While a majority of patients identified triggering events preceding their IAE diagnosis, 32% had unidentified triggers. This study demonstrates that long-term IG therapy is prescribed more often than one-time IG orders for IAE diagnoses.