Ugarte Shannon, Gebhard Talia, Cornblath David R, Scherer Steven S, Babushok Daria V
Department of Medicine Division of Hematology-Oncology University of Pennsylvania Philadelphia Pennsylvania USA.
MD Program Drexel University College of Medicine Drexel University Philadelphia Pennsylvania USA.
EJHaem. 2025 Jan 27;6(1):e1102. doi: 10.1002/jha2.1102. eCollection 2025 Feb.
Intravenous immunoglobulin (IVIG) is an immunomodulatory therapy derived from pooled donor immunoglobulins and used for treatment of various autoimmune conditions. Here we report the diagnosis and management of IVIG-induced chronic severe neutropenia with absolute neutrophil count <0.5×10/µL in a patient with multifocal motor neuropathy. Serial blood count showed a cyclical pattern of neutropenia: worsening 24-48 h post-IVIG, then gradually improving before the next infusion. IVIG-induced neutropenia is rare, with previous reports of predominantly mild transient neutropenia. Our case describes chronic severe neutropenia that developed years after starting IVIG. We summarize available evidence and management strategies for IVIG-associated neutropenia.
静脉注射免疫球蛋白（IVIG）是一种从混合供体免疫球蛋白中提取的免疫调节疗法，用于治疗各种自身免疫性疾病。在此，我们报告了一例多灶性运动神经病患者发生IVIG诱导的慢性严重中性粒细胞减少症，其绝对中性粒细胞计数<0.5×10⁹/µL的诊断和管理情况。连续血常规显示中性粒细胞减少呈周期性模式：IVIG治疗后24 - 48小时病情恶化，然后在下一次输注前逐渐改善。IVIG诱导的中性粒细胞减少症较为罕见，既往报道主要为轻度短暂性中性粒细胞减少症。我们的病例描述了在开始使用IVIG数年后发生的慢性严重中性粒细胞减少症。我们总结了IVIG相关中性粒细胞减少症的现有证据和管理策略。
