Vucic S, Chong P Siao Tick, Dawson K T, Cudkowicz M, Cros D
Massachusetts General Hospital, Boston, Mass. 021114, USA.
Eur Neurol. 2004;52(3):141-4. doi: 10.1159/000081465. Epub 2004 Oct 12.
Intravenous immunoglobulin (IVIg) preparations are increasingly being used in the treatment of neuroautoimmune diseases. Although for most part this treatment is safe, serious side effects such as thromboembolic events have been reported. We report on 7 patients who suffered a thromboembolic event while being treated with IVIg. Four patients suffered a stroke or transient ischemic attack, 1 an inferior wall myocardial infarction, 1 a deep venous thrombosis, and 1 a retinal artery infarct. The age range of the patients was 57-81 and most had underlying risk factors, such as hypertension, hypercholesterolemia, atrial fibrillation, history of vascular disease and stroke, and deep venous thrombosis. Three patients received multiple IVIg infusions before suffering a thromboembolic complication. Therefore, the clinicians should be vigilant about the possibility of thromboembolic complications with each IVIg infusion and be especially judicious with the use of IVIg in patients with underlying risk factors.
静脉注射免疫球蛋白(IVIg)制剂越来越多地用于治疗神经自身免疫性疾病。尽管在大多数情况下这种治疗是安全的,但已报告了诸如血栓栓塞事件等严重副作用。我们报告了7例在接受IVIg治疗时发生血栓栓塞事件的患者。4例患者发生中风或短暂性脑缺血发作,1例发生下壁心肌梗死,1例发生深静脉血栓形成,1例发生视网膜动脉梗死。患者年龄范围为57 - 81岁,大多数有潜在危险因素,如高血压、高胆固醇血症、心房颤动、血管疾病和中风病史以及深静脉血栓形成。3例患者在发生血栓栓塞并发症之前接受了多次IVIg输注。因此,临床医生在每次输注IVIg时应警惕血栓栓塞并发症的可能性,对于有潜在危险因素的患者使用IVIg时应格外审慎。