Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Muscle Nerve. 2020 Sep;62(3):327-332. doi: 10.1002/mus.26884. Epub 2020 Apr 18.
Our aim in this study was to determine whether intravenous immunoglobulin (IVIg) or plasma exchange (PLEx) for treatment of neurologic disease is a trigger for thrombotic events.
Using administrative data from 2005 to 2014, we identified index admissions for thrombotic events. We performed case-crossover analyses for these admissions with previous admissions for neurologic disease with IVIg or PLEx using exposure periods of between 7 and 120 days.
We identified 1.9 million admissions for venous thrombosis embolism, myocardial infarction, or acute ischemic stroke. The odds ratio for venous thrombosis embolism within a 30-day window after exposure to IVIg was 3.33 (1.34-8.30, P = .0097) and for PLEx was 4.29 (1.88-9.76, P = .0005). Myocardial infarction and acute ischemic stroke admissions were not associated with exposure to either therapy.
Patients admitted for venous thrombosis embolism (but not acute ischemic stroke or myocardial infarction) were more likely exposed to either IVIg or PLEx during previous admission for neurologic disease.
本研究旨在确定静脉注射免疫球蛋白（IVIg）或血浆置换（PLEx）治疗神经疾病是否会引发血栓事件。
我们使用 2005 年至 2014 年的行政数据，确定了血栓事件的入院病例。我们对这些病例进行了病例交叉分析，以确定之前接受过 IVIg 或 PLEx 治疗的神经疾病患者的入院情况，暴露期为 7 至 120 天。
我们共确定了 190 万例静脉血栓栓塞、心肌梗死或急性缺血性卒中的入院病例。在暴露于 IVIg 后 30 天内，静脉血栓栓塞的比值比为 3.33（1.34-8.30，P =.0097），PLEx 的比值比为 4.29（1.88-9.76，P =.0005）。心肌梗死和急性缺血性卒中的入院病例与两种治疗方法均无相关性。
静脉血栓栓塞（而非急性缺血性卒中或心肌梗死）患者在之前因神经疾病住院期间，更有可能接触到 IVIg 或 PLEx。
