HYPERONCOTIC ACUTE-RENAL-FAILURE AFTER IN TRAVENOUS IMMUNOGLOBULIN THERAPY

In idiopathic thrombocytopenic purpura, intravenous immunoglobulin the rapy is currently a treatment of choice. It is usually effective with little side-effects. Acute renal failure has been recently identified as a potential, though rare, complication of intravenous immunoglobuli ns. However, the mechanism remains unclear. A 53 year-old-woman with i diopathic thrombocytopenic purpura developed oliguric renal failure af ter high doses of intravenous immunoglobulins. Her renal function retu rned to normal after dialysis and plasmapheresis. This rapid normaliza tion suggested that acute renal failure was functional. Since laborato ry tests showed an increase in protidemia concomitant to the immunoglo bulin therapy, acute renal failure was likely to be related to hyperos molar renal damage.