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Tytuł:
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Thromboembolic complications following intravenous immunoglobulin therapy in immune-mediated neurological disorders.
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Autorzy:
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Chun W; Department of Neurology, Inha University Hospital, Incheon, Republic of Korea.
Kim Y; Department of Neurology, Inha University Hospital, Incheon, Republic of Korea.
Park SH; Department of Neurology, Inha University Hospital, Incheon, Republic of Korea; Department of Critical Care Medicine, Inha University Hospital, Incheon, Republic of Korea.
Choi SJ; Department of Neurology, Inha University Hospital, Incheon, Republic of Korea; Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: .
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Źródło:
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Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia [J Clin Neurosci] 2021 Aug; Vol. 90, pp. 311-316. Date of Electronic Publication: 2021 Jun 21.
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Typ publikacji:
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Case Reports; Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: <2000->: Edinburgh : Churchill Livingstone
Original Publication: Melbourne, Vic., Australia : Churchill Livingstone, c1994-
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MeSH Terms:
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Immunization, Passive/*adverse effects
Immunoglobulins, Intravenous/*adverse effects
Nervous System Diseases/*complications
Nervous System Diseases/*therapy
Thromboembolism/*complications
Aged, 80 and over ; Critical Illness ; Female ; Guillain-Barre Syndrome/complications ; Guillain-Barre Syndrome/therapy ; Humans ; Immunoglobulins, Intravenous/therapeutic use ; Ischemic Stroke/etiology ; Male ; Middle Aged ; Myasthenia Gravis/complications ; Myasthenia Gravis/therapy ; Pulmonary Embolism/etiology ; Retrospective Studies
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Contributed Indexing:
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Keywords: Complication; Intravenous immunoglobulin; Neurological disorders; Thromboembolism
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Substance Nomenclature:
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0 (Immunoglobulins, Intravenous)
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Entry Date(s):
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Date Created: 20210719 Date Completed: 20210723 Latest Revision: 20210723
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Update Code:
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20240105
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DOI:
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10.1016/j.jocn.2021.06.021
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PMID:
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34275568
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Background: Minor adverse events of intravenous immunoglobulin (IVIg) include flu-like symptoms, eczematous skin reaction, electrolyte disturbance, and transient leukopenia. On rare occasions, serious complications such as aseptic meningitis, arrhythmia, decrease in blood pressure, and thromboembolic complications (TEC) have been described. The current study aimed to understand the frequency and clinical features of TEC related to IVIg administration in patients with immune-mediated neurological disorders.
Methods: We conducted a retrospective chart review of hospitalized patients with immune-mediated neuromuscular or neuroimmunological disorders treated with IVIg from January 2018 to March 2020 in a single tertiary hospital.
Results: During the study period, 61 patients were treated with a total of 364 IVIg infusions over 84 treatment courses. Among them, we identified 3 TEC cases that occurred during or after the completion of IVIg therapy: two patients with myasthenia gravis (F/60 and F/80) and one patient with Guillain-Barré syndrome (F/79) had undergone arterial TEC (two for ischemic stroke and one for pulmonary thromboembolism). The rates of TEC per patient, per treatment course, and per infusion were 4.91% (3/61), 3.57% (3/84), and 0.82% (3/364), respectively.
Conclusion: The risk of developing TEC upon receiving IVIg infusions is generally low in patients with immune-mediated neurological disorders; however, IVIg-related TEC should be cautiously monitored for in critically ill elderly patients with vascular risk factors, especially those suffering from myasthenic crisis.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2021 Elsevier Ltd. All rights reserved.)
