Potential for abuse of buprenorphine in office-based treatment of opioid dependence.

1863 liter three years before admission. Instead of providing immediate immune globulin replacement on admission, his clinicians remeasured the serum IgG five days later (130 mg per deciliter), and immune globulin replacement was given seven days after admission. The patient died on the 12th hospital day. There is an extensive body of literature supporting the value of intravenous immune globulin replacement for patients with CLL with hypogammaglobulinemia and infection.2-4 The cause of death in this case was determined to be West Nile encephalitis, and case reports suggest that intravenous immune globulin may be therapeutic in such patients without hypogammaglobulinemia.5 The managing clinicians did not explain the delay in providing replacement, and the discussant did not address the likelihood that immediate immune globulin replacement might have prevented the fatal outcome in this case. Because this was a teaching case, their informed opinions could be valuable.