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[Haemolytic anaemia as a complication to intravenous infusion of human immunoglobulin]. 2011

Jacob Juel, and Lars Høj Markvardsen, and Johannes Jakobsen
Neurologisk Afdeling F, Aarhus Universitetshospital, Aarhus Sygehus, Denmark. jju@studmed.au.dk

A 85-year-old female treated for chronic inflammatory demyelinating polyradiculoneuropathy had three episodes of anaemia one week following treatment with large doses (2g/kg body weight) of immunoglobulin (Ig). At the final episode, she presented with haemolytic anaemia with fatigue, jaundice and loss of appetite. During the next two months anaemia was recognized in two additional cases. Subsequently, a series of twelve conseuntively studied IVIg treated patients showed a significant decrease of haemoglobin of 0.80 mmol/l 8-15 days after infusion. Haemolytic anaemia is a severe side effect that seems to be more frequent than previously recognized. It may possibly be prevented by the use of lyophilized Ig-preparations with low isohaemagglutinin titers or by slower Ig infusion rates.

UI MeSH Term Description Entries
D008297 Male Males
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D000743 Anemia, Hemolytic A condition of inadequate circulating red blood cells (ANEMIA) or insufficient HEMOGLOBIN due to premature destruction of red blood cells (ERYTHROCYTES). Anemia, Hemolytic, Acquired,Anemia, Microangiopathic,Haemolytic Anaemia,Hemolytic Anemia,Hemolytic Anemia, Acquired,Microangiopathic Hemolytic Anemia,Acquired Hemolytic Anemia,Anaemia, Haemolytic,Anemia, Acquired Hemolytic,Anemia, Microangiopathic Hemolytic,Haemolytic Anaemias,Hemolytic Anemia, Microangiopathic,Microangiopathic Anemia,Microangiopathic Hemolytic Anemias
D016756 Immunoglobulins, Intravenous Immunoglobulin preparations used in intravenous infusion, containing primarily IMMUNOGLOBULIN G. They are used to treat a variety of diseases associated with decreased or abnormal immunoglobulin levels including pediatric AIDS; primary HYPERGAMMAGLOBULINEMIA; SCID; CYTOMEGALOVIRUS infections in transplant recipients, LYMPHOCYTIC LEUKEMIA, CHRONIC; Kawasaki syndrome, infection in neonates, and IDIOPATHIC THROMBOCYTOPENIC PURPURA. Antibodies, Intravenous,Human Intravenous Immunoglobulin,IV Immunoglobulin,IVIG,Intravenous Antibodies,Intravenous Immunoglobulin,Intravenous Immunoglobulins,Alphaglobin,Endobulin,Flebogamma DIF,Gamimmune,Gamimmune N,Gamimune,Gamimune N,Gammagard,Gammonativ,Gamunex,Globulin-N,IV Immunoglobulins,Immune Globulin Intravenous (Human),Immune Globulin, Intravenous,Immunoglobulins, Intravenous, Human,Intraglobin,Intraglobin F,Intravenous IG,Intravenous Immunoglobulins, Human,Iveegam,Modified Immune Globulin (Anti-Echovirus Antibody),Privigen,Sandoglobulin,Venimmune,Venoglobulin,Venoglobulin-I,Globulin N,Human Intravenous Immunoglobulins,Immunoglobulin, Human Intravenous,Immunoglobulin, IV,Immunoglobulin, Intravenous,Immunoglobulins, Human Intravenous,Immunoglobulins, IV,Intravenous Immune Globulin,Intravenous Immunoglobulin, Human,Venoglobulin I
D020275 Guillain-Barre Syndrome An acute inflammatory autoimmune neuritis caused by T cell- mediated cellular immune response directed towards peripheral myelin. Demyelination occurs in peripheral nerves and nerve roots. The process is often preceded by a viral or bacterial infection, surgery, immunization, lymphoma, or exposure to toxins. Common clinical manifestations include progressive weakness, loss of sensation, and loss of deep tendon reflexes. Weakness of respiratory muscles and autonomic dysfunction may occur. (From Adams et al., Principles of Neurology, 6th ed, pp1312-1314) Acute Autoimmune Neuropathy,Acute Inflammatory Demyelinating Polyradiculoneuropathy,Acute Inflammatory Polyneuropathy,Landry-Guillain-Barre Syndrome,Polyradiculoneuropathy, Acute Inflammatory,Acute Infectious Polyneuritis,Acute Inflammatory Demyelinating Polyneuropathy,Acute Inflammatory Polyradiculoneuropathy,Demyelinating Polyradiculoneuropathy, Acute Inflammatory,Guillain-Barre Syndrome, Familial,Guillain-Barré Syndrome,Guillaine-Barre Syndrome,Inflammatory Demyelinating Polyradiculoneuropathy, Acute,Inflammatory Polyneuropathy Acute,Polyneuropathy, Acute Inflammatory,Polyneuropathy, Inflammatory Demyelinating, Acute,Polyradiculoneuropathy, Acute Inflammatory Demyelinating,Acute Autoimmune Neuropathies,Acute Inflammatory Polyneuropathies,Acute Inflammatory Polyradiculoneuropathies,Autoimmune Neuropathies, Acute,Autoimmune Neuropathy, Acute,Familial Guillain-Barre Syndrome,Familial Guillain-Barre Syndromes,Guillain Barre Syndrome,Guillain Barre Syndrome, Familial,Guillain Barré Syndrome,Guillain-Barre Syndromes, Familial,Guillain-Barré Syndromes,Guillaine Barre Syndrome,Infectious Polyneuritis, Acute,Inflammatory Polyneuropathies, Acute,Inflammatory Polyneuropathy, Acute,Inflammatory Polyradiculoneuropathies, Acute,Landry Guillain Barre Syndrome,Neuropathy, Acute Autoimmune,Polyneuritis, Acute Infectious,Polyneuropathy Acute, Inflammatory,Polyradiculoneuropathies, Acute Inflammatory,Syndrome, Familial Guillain-Barre,Syndrome, Guillain-Barre,Syndrome, Guillain-Barré,Syndrome, Guillaine-Barre,Syndrome, Landry-Guillain-Barre
D020277 Polyradiculoneuropathy, Chronic Inflammatory Demyelinating A slowly progressive autoimmune demyelinating disease of peripheral nerves and nerve roots. Clinical manifestations include weakness and sensory loss in the extremities and enlargement of peripheral nerves. The course may be relapsing-remitting or demonstrate a step-wise progression. Protein is usually elevated in the spinal fluid and cranial nerves are typically spared. GUILLAIN-BARRE SYNDROME features a relatively rapid progression of disease which distinguishes it from this condition. (Adams et al., Principles of Neurology, 6th ed, p1337) CIDP,Chronic Inflammatory Demyelinating Polyradiculoneuropathy,Chronic Inflammatory Polyradiculoneuropathy,Inflammatory Polyradiculopathy, Chronic,Polyneuropathy, Inflammatory Demyelinating, Chronic,Polyradiculoneuropathy, Chronic Inflammatory,Chronic Inflammatory Polyradiculoneuropathies,Chronic Inflammatory Polyradiculopathies,Chronic Inflammatory Polyradiculopathy,Inflammatory Polyradiculoneuropathies, Chronic,Inflammatory Polyradiculoneuropathy, Chronic,Inflammatory Polyradiculopathies, Chronic,Polyradiculoneuropathies, Chronic Inflammatory,Polyradiculopathies, Chronic Inflammatory,Polyradiculopathy, Chronic Inflammatory

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