title: Splenic rupture associated with primary CMV infection, AMSAN, and IVIG.
abstract: Splenic rupture is a rare complication of primary cytomegalovirus infection, but has not been reported after administration of intravenous immunoglobulin or in the setting of the Guillain-Barré syndrome and its many variants, which often lead to treatment with intravenous immunoglobulin. There is strong evidence that intravenous immunoglobulin causes sequestration of erythrocytes in the spleen and extravascular hemolytic anemia. This may result in a two-hit scenario that clinicians should be aware of, where a patient who is at risk for splenic rupture due to primary cytomegalovirus infection receives intravenous immunoglobulin as treatment for the cytomegalovirus-associated Guillain-Barré syndrome, further increasing their risk of rupture.
authors.affiliation: University of Washington, Department of Neurology, 2407 Federal Ave E, Seattle, WA 98102, USA. Electronic address: ahdh@uw.edu.
authors.forename: Adam
authors.initials: A
authors.lastname: de Havenon
authors.affiliation: University of Utah, Department of Pharmacy, 75 North Medical Drive, Salt Lake City, UT 84132, USA. Electronic address: gary.davis@hsc.utah.edu.
authors.forename: Gary
authors.initials: G
authors.lastname: Davis
authors.affiliation: University of Utah, Department of Neurology, USA. Electronic address: robert.hoesch@hsc.utah.edu.
authors.forename: Robert
authors.initials: R
authors.lastname: Hoesch
mesh_terms: D000328:Adult; D003586:Cytomegalovirus Infections / Q000150:complications*; D020275:Guillain-Barre Syndrome / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D008297:Male; D013161:Splenic Rupture / Q000209:etiology* / Q000821:virology
chemical_list: D016756:Immunoglobulins, Intravenous
keywords: AMSAN; Cytomegalovirus; Guillain–Barré syndrome; Hemolysis; Intravenous immunoglobulin; Splenic rupture