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  1. Four or more new ear infections within 1 year.
  2. Two or more serious sinus infections within 1 year.
  3. Two or more months on antibiotics with little effect.
  4. Two or more pneumonias within 1 year.
  5. Failure of an infant to gain weight or grow normally.
  6. Recurrent, deep skin or organ abscesses.
  7. Persistent thrush in mouth or fungal infection on skin.
  8. Need for intravenous antibiotics to clear infections.
  9. Two or more deep-seated infections, including septicemia.
  10. A family history of PI.


Primary immunodeficiency disease consists of more than 350 rare, chronic disorders involving a compromised or incomplete immune system. These disorders are not contagious and often present at birth (due to hereditary or genetic defects) and can impact any race, age, or gender. While some disorders impact multiple components of the immune system, others can impact only one, resulting in the inability of the body to fight infection.2

Exact prevalence is unknown but, in the United States, it is estimated that 1 in 2000 children and 1 in 600 households (or an estimated 150,000 to 360,000 people) are diagnosed with PI.3

Those suffering with PI often get one infection after another. These infections may never really improve as expected and may reoccur over time. In more severe forms of PI, even certain infections considered "less serious" in individuals with normal immune systems, may cause serious, life-threatening infections in those with PI.4

Also, certain PIs are associated with immune system disorders such as anemia, arthritis, or autoimmune diseases. Other PIs increase the risk of cancer, stunt growth, or impact the heart, digestive tract, or the nervous system.4


In a survey of patients with primary immunodeficiency, the Immune Deficiency Foundation (IDF) "National Survey of Patients: 2008," only 10% of the responding 1030 patients never missed any day of work or school prior to diagnosis. In the same survey, patients reported that they missed an average of 36.8 days of work or school prior to diagnosis.5


If left untreated, PI can lead to serious health issues. If someone in your family has PI it is important to have other family members checked for signs and symptoms and evaluated for PI as soon as possible.

This information is not intended to be a substitute for professional medical care. You should consult your family physician or pediatrician for specific information on the diagnosis, treatment, and clinical care of patients with PI.


1Jeffrey Modell Foundation. National Primary Immunodeficiency Resource Center. 10 warning signs of primary immunodeficiency. Accessed October 20, 2017.

2Immune Deficiency Foundation. About primary immunodeficiency diseases. Accessed October 20, 2017.

3Jiang F, Torgerson TR, Ayars AG. Health-related quality of life in patients with primary immunodeficiency diseases. Allergy Asthma Clin Immunol. 2015;11:27.

4National Institutes of Health. National Institute of Child Health and Human Development. Primary immunodeficiency: when the body's defenses are missing. Bethesda, MD: National Institutes of Health; 1999. Accessed November 13, 2017.

5Immune Deficiency Foundation. Treatment Experiences and Preferences among Patients with Primary Immunodeficiency Disease, National Survey of Patients: 2008.

Important Safety Information for BIVIGAM [Immune Globulin Intravenous (Human), 10% Liquid]

BIVIGAM [Immune Globulin Intravenous (Human), 10% Liquid] is indicated for the treatment of primary humoral immunodeficiency (PI). This includes, but is not limited to, the humoral immune defect in common variable immunodeficiency (CVID), X-linked agammaglobulinemia, congenital agammaglobulinemia, Wiskott-Aldrich syndrome, and severe combined immunodeficiencies (SCID).


  • Thrombosis may occur with immune globulin intravenous (IGIV) products, including BIVIGAM. Risk factors may include: advanced age, prolonged immobilization, hypercoagulable conditions, a history of venous or arterial thrombosis, the use of estrogens, indwelling vascular catheters, hyperviscosity and cardiovascular risk factors.
  • Use of immune globulin intravenous (IGIV) products, particularly those containing sucrose, has been reported to be associated with renal dysfunction, acute renal failure, osmotic nephrosis, and death. Patients at risk of acute renal failure include those with any degree of pre-existing renal insufficiency, diabetes mellitus, advanced age (above 65 years of age), volume depletion, sepsis, paraproteinemia, or receiving known nephrotoxic drugs.
  • Renal dysfunction and acute renal failure occur more commonly in patients receiving IGIV products containing sucrose. BIVIGAM does not contain sucrose.
  • For patients at risk of thrombosis, renal dysfunction, or renal failure, administer BIVIGAM at the minimum dose and infusion rate practicable. Ensure adequate hydration in patients before administration. Monitor for signs and symptoms of thrombosis and assess blood viscosity in patients at risk for hyperviscosity.

BIVIGAM is contraindicated in patients who have had an anaphylactic or severe systemic reaction to the administration of human immune globulin and in IgA-deficient patients with antibodies to IgA and history of hypersensitivity.

Thrombosis may occur following treatment with IGIV products, including BIVIGAM. Thrombosis may occur in the absence of known risk factors.

Consider baseline assessment of blood viscosity in patients at risk for hyperviscosity, including those with cryoglobulins, fasting chylomicronemia/markedly high triacylglycerols (triglycerides), or monoclonal gammopathies. For patients at risk of thrombosis, administer BIVIGAM at the minimum dose and infusion rate practicable.

In patients at risk of developing acute renal failure, renal function, including blood urea nitrogen (BUN), serum creatinine, and urine output need to be monitored.

Hyperproteinemia, increased serum viscosity, and hyponatremia or pseudohyponatremia can occur in patients receiving IGIV therapy. Aseptic meningitis syndrome (AMS) has been reported with IGIV treatments; AMS may occur more frequently in association with high doses (2 g/kg) and/or rapid infusion of IGIV.

As hemolysis can develop subsequent to treatment with IGIV products, monitor patients for hemolysis and hemolytic anemia. Monitor patients for pulmonary adverse reactions (transfusion-related acute lung injury [TRALI]). If TRALI is suspected, test the product and patient for antineutrophil antibodies.

Because BIVIGAM is made from human blood, it may carry a risk of transmitting infectious agents, e.g., viruses, and theoretically, the Creutzfeldt-Jakob disease (CJD) agent.

Passive transfer of antibodies with IGIV treatment may yield positive serological testing results, with the potential for misleading interpretation.

Serious adverse reactions observed in clinical trial subjects receiving BIVIGAM were vomiting and dehydration in one subject. The most common adverse reactions to BIVIGAM (reported in ≥ 5% of clinical study subjects) were headache, fatigue, infusion site reaction, nausea, sinusitis, blood pressure increase, diarrhea, dizziness, and lethargy.

You are encouraged to report side effects of prescription drugs to ADMA Biologics at 1-800-458-4244 or the FDA. Visit or call 1-800-FDA-1088.

For more information about BIVIGAM, please see full Prescribing Information.