Conditions that may require Biological Treatments

There are many different medical conditions that require intravenous management.

The Cape Town Infusion Centre has experience in a number of these conditions and will assist you in the administration of your prescribed intravenous treatment.

Conditions that may require intravenous Treatments:

AUTOIMMUNE DISEASES:

There are a range of autoimmune diseases that may receive biologic medications as part of their management.

  • INFLAMMATORY BOWEL DISEASE

Crohn’s Disease and Ulcerative Colitis are autoimmune diseases of the intestinal tract. These are life-long conditions that require ongoing management.

Both children and adults can be affected by Inflammatory Bowel Disease and the Cape Town Infusion Centre is experienced at both paediatric and adult biologic administration.

For more information about Inflammatory Bowel Disease please click here

  • RHEUMATIC DISEASES:

Rheumatoid Arthritis, Axial spondyloarthritis, Psoriatic Arthritis, Giant cell Arteritis and Juvenile Idiopathic Arthritis are all autoimmune inflammatory conditions of the joints and can include the skin.

Both Children and adults can be affected by these diseases.

Good management is essential in order to prevent joint damage and biologics can play a critical role in the management of these conditions

For more information about Rheumatic Diseases please click here

  • PRE-RENAL TRANSPLANT:

Some patients who have positive flow crossmatch and donor specific antibodies will require desensitisation prior to renal transplant.

This medication is administered through intravenous infusion over 5-6 hours and requires specialised management.

Conditions that may require Intravenous Iron:

IRON DEFICIENCY / IRON DEFICIENCY ANAEMIA:

People from all walks of life can struggle with iron deficiency and /or iron deficiency anaemia (ID / IDA). Iron deficiency occurs when your iron stores are very low and this may lead to anaemia – a low haemoglobin, if not corrected.

Physical factors such as heavy menstrual bleeding or pregnancy, environmental factors such as inadequate nutrition, stress, inflammation due to auto-immune conditions and certain medications are just some of the many causes of low iron stores. Some symptoms of ID / IDA may be fatigue, poor effort tolerance, restless legs, poor concentration and mental processing, hair loss and low mood.

DID YOU KNOW?

• Globally 38.8% of pregnant women are anaemic

• In Africa, 57% of pregnant women suffered from anaemia in 2019

• In South Africa, more than 40% of children aged 6 months to 5 years were categorised anaemic in 2019

  • ID/ IDA OF CHRONIC DISEASE

These conditions may include Rheumatology conditions, Inflammatory Bowel Disease, Chronic Kidney Disease, and Oncology.

Chronic conditions may cause ID/IDA.  This can be due to inflammatory pathways and the body’s inability to absorb iron under these conditions.

Intravenous iron can help to correct these low iron stores and improve quality of life

  • ID/IDA OF PREGNANCY:

Pregnancy places larger than normal demands on a woman’s iron stores.  The growing foetus requires iron for development and the placenta utilises the mother’s iron stores for this.

It is critical for maternal and foetal well being that ID/IDA is corrected in pregnancy prior to the baby’s delivery.

ID/IDA in a new-born can have long term effects that can last a lifetime.

Intravenous iron is safe to use in pregnancy when prescribed by a medical professional and can be of enormous benefit to both baby and mother.

  • PRE-SURGICAL ID/IDA:

In patients undergoing surgery intravenous iron is critical in enhancing good surgical outcomes in the anaemic patient.

As part of Patient Blood Management Programmes, it has been shown that intravenous iron is not only beneficial but lower risk that whole blood transfusions.

Intravenous iron can be given prior to surgery and post-surgery in the setting of increased surgical blood loss.

  • GYNAECOLOGICAL ID/IDA:

Heavy menstrual bleeding over time can result in ID/IDA.  Iron stores within the body cannot keep up with the monthly blood loss and women become ID / Anaemic.  Oral iron can be used but if there is no response to this treatment or it cannot be tolerated it is essential to correct the ID/IDA.

It is also critical to address the cause of the heavy menstrual bleeding so as to prevent ongoing ID/IDA.

  • GASTROINTESTINAL BLOOD LOSS:

ID/IDA can be as a result of intestinal blood loss through several conditions such a bleeding gastric ulcer, intestinal bleeding or haemorrhoids.  Intravenous iron helps to correct the ID/IDA, but the cause of the blood loss needs to be managed.

  • ID/IDA IN THE ELDERLY:

ID/IDA is common in the elderly population and can be caused by poor diet, poly pharmacy, decreased intestinal absorption or slow gastrointestinal blood loss.  Anaemia in the elderly should be investigated to find the cause as well as treated to improved quality of life.

  • OTHER CAUSES OF ID/IDA

Poor gastrointestinal absorption of iron – this can be due to genetic factors, people using PPIs for reflux, other medications.

Unexplained ID/IDA – sometimes there is no overt reason for ID/IDA.

Conditions that may require Bisphosphonate treatment:

BONE DISEASES:

  • OSTEOPOROSIS:

Osteoporosis is a disease that involves the thinning and weakening of the bones and is common in women after menopause but can also occur in men.

Bisphosphonates are a group of medicines that are used to treat osteoporosis. Osteoporosis can have a number of causes and can affect certain groups of people for example post-menopausal women.  It can also affect men or women who are treated with longer term corticosteroids for inflammation.

  • PAGET’S DISEASE OF THE BONE:

It is normal that old bone is removed and is replaced with new bone material. This process is called remodelling. In Paget’s disease, bone remodelling is too rapid and new bone is formed in a disordered fashion, which makes it weaker than normal. If the disease is not treated, bones may become deformed and painful, and may break.

Conditions that may require high dose Intravenous steroid treatment

  • EARLY TRASPLANT REJECTION:

In early renal transplant rejection, some patients can be managed by daily high dose intravenous steroids give on consecutive days for a set period of time.

  • PERIORBITAL / ORBITAL SWELLING

High doses of IV cortisone can help to reduce the inflammatory process associated with peri-orbital and orbital swelling.