COMPLICATIONS OF INTRAVENOUS IMMUNE GLOBULIN TREATMENT IN NEUROLOGIC DISEASE

Intravenous immune globulin (IVIg) is advocated as a safe treatment fo r immune-mediated neurologic disease. We reviewed the medical records of 88 patients who were given IVIg for a neurologic illness. Major com plications in four patients (4.5%) included congestive heart failure i n a patient with polymyositis, hypotension after a recent myocardial i nfarction, deep venous thrombosis in a bed-bound patient, and acute re nal failure with diabetic nephropathy. Other adverse effects included vasomotor symptoms 26, headache 23, rash 5, leukopenia 4, fever 3, neu tropenia 1, proteinuria (1.9 g/day) 1, viral syndrome 1, dyspnea 1, an d pruritis 1. Fifty-two patients (59%) had some adverse effect of Mg i nfusion, most commonly vasomotor symptoms, headaches, fever, or shortn ess of breath in 40 (45%), which improved with reduced infusion rate o r symptomatic medications. Five (6%) bad asymptomatic laboratory abnor malities and seven (8%) had other minor adverse effects. Adverse effec ts led to discontinuation of therapy in 16% and permanent termination of therapy in 10% of patients. There was no mortality or long-term mor bidity. Although adverse effects were frequent, serious complications were rare except in patients with heart disease, renal insufficiency, and bed-bound state.