title: Fatal case of bilateral internal jugular vein thrombosis following IVIg infusion in an adolescent girl treated for ITP.
abstract: Intravenous immunoglobulin (IVIg) is often used as therapy in immune-mediated diseases and is generally considered a safe therapeutic agent. However, thrombotic complications such as myocardial infarction and deep vein thrombosis have been reported, although primarily in older adults. We describe a 13-year-old girl who received one dose of IVIg for immune thrombocytopenic purpura and developed fatal bilateral jugular venous thromboses. This is the first known case of IVIg-associated thrombosis in an adolescent and also the first report describing internal jugular vein thrombosis associated with IVIg infusion. We identify additional risks that may potentiate the agent's thrombotic risk.
authors.affiliation: Department of Pediatrics, Baystate Children's Hospital, Tufts University School of Medicine, 759 Chestnut St, Springfield, MA 01199, USA. pui-ying.irohtam@bhs.org
authors.forename: Pui-Ying
authors.initials: PY
authors.lastname: Iroh Tam
authors.forename: Matthew
authors.initials: M
authors.lastname: Richardson
authors.forename: SatKiran
authors.initials: S
authors.lastname: Grewal
mesh_terms: D000293:Adolescent; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy / Q000209:etiology; D000925:Anticoagulants / Q000627:therapeutic use; D001929:Brain Edema / Q000209:etiology*; D003131:Combined Modality Therapy; D003907:Dexamethasone / Q000627:therapeutic use; D004997:Ethinyl Estradiol / Q000009:adverse effects / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects*; D007262:Infusions, Intravenous; D007601:Jugular Veins; D008353:Mannitol / Q000627:therapeutic use; D008796:Metrorrhagia / Q000188:drug therapy / Q000209:etiology; D009640:Norethindrone / Q000009:adverse effects / Q000627:therapeutic use; D009765:Obesity / Q000150:complications; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications / Q000628:therapy*; D017131:Thrombectomy; D015912:Thrombolytic Therapy; D020246:Venous Thrombosis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery
chemical_list: D000925:Anticoagulants; D016756:Immunoglobulins, Intravenous; D008353:Mannitol; D004997:Ethinyl Estradiol; D003907:Dexamethasone; D006493:Heparin; D009640:Norethindrone