Intravenous immunoglobulin, blood viscosity and myocardial infarction.
Polyvalent intravenous immunoglobulin (IVIg) is considered to be standard therapy for a variety of autoimmune and idiopathic disorders. Several reports have emphasized the temporal association between administration of IVIg and thrombotic events. Recent experience with a patient who suffered a large myocardial infarction shortly after receiving IVIg led the authors to review the clinical and basic literature on administration of IVIg as a possible precipitant for myocardial infarction. Although the existence of an association between IVIg administration and myocardial ischemia has not been demonstrated in clinical trials, a body of clinical experience has begun to accumulate that is suggestive of an association between IVIg administration and cardiac and cerebral ischemia in older individuals or individuals with a known history of ischemic disease. Basic research demonstrating that IVIg administration may increase blood viscosity suggests that such an association is plausible.
Fisman
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Department of Medicine, Royal Victoria Hospital, Montreal, Quebec. dfisman@bidmc.harvard.edu
Smilovitch
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M
D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy; D001809:Blood Viscosity / Q000187:drug effects*; D002908:Chronic Disease; D003711:Demyelinating Diseases / Q000188:drug therapy*; D017809:Fatal Outcome; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage / Q000009:adverse effects*; D007275:Injections, Intravenous; D008297:Male; D009203:Myocardial Infarction / Q000139:chemically induced*; D011115:Polyneuropathies / Q000188:drug therapy
D007136:Immunoglobulins