title: Thrombotic complications after intravenous immunoglobulin therapy in two patients.
abstract: Although intravenous immunoglobulin (IVIg) generally is considered a safe treatment for various autoimmune and inflammatory disorders, rare cases of thrombosis may occur. We describe two patients who experienced thrombotic complications associated with IVIg therapy. A 54-year-old woman with idiopathic thrombocytopenia received IVIg 1 g/kg/day for 2 days. While receiving her infusion on day 2, she had an ischemic stroke with hemiparesis; 3 days later she developed deep vein thrombosis. A 33-year-old woman with Evans' syndrome received IVIg 400 mg/kg/day for 5 days and developed deep vein thrombosis 1 week after therapy was completed; she then received warfarin. Six months later, she received an additional course of IVIg for recurrent hemolytic anemia; 1 day later she died of pulmonary thromboembolism. We suggest that IVIg may promote thrombosis by increasing blood viscosity, activating platelets, or causing vasospasm and should be administered with caution.
authors.affiliation: Wilmer Eye Institute, Johns Hopkins Medical Center, Baltimore, Maryland, USA.
authors.forename: Geoffrey G
authors.initials: GG
authors.lastname: Emerson
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Herndon
authors.forename: Antoine G
authors.initials: AG
authors.lastname: Sreih
mesh_terms: D000328:Adult; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects*; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000139:chemically induced / Q000517:prevention & control; D012307:Risk Factors; D020246:Venous Thrombosis / Q000139:chemically induced* / Q000517:prevention & control
chemical_list: D016756:Immunoglobulins, Intravenous