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一名慢性炎症性脱髓鞘性多发性神经病患者静脉注射免疫球蛋白后出现晕厥及新发双分支阻滞

Syncope and New-Onset Bifascicular Block Associated With Intravenous Immunoglobulin in a Patient With Chronic Inflammatory Demyelinating Polyneuropathy.

作者信息

Wolchover Trevor, Dosanjh Harpreet, Lalezari Jonathan, Delote Isaac, Takher Jasprit

机构信息

Internal Medicine, Los Robles Regional Medical Center, Thousand Oaks, USA.

出版信息

Cureus. 2025 Apr 10;17(4):e82010. doi: 10.7759/cureus.82010. eCollection 2025 Apr.

Abstract

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated neuropathy often treated with intravenous immunoglobulin (IVIG), which is generally well-tolerated but has occasionally been associated with rare cardiovascular side effects. We present the case of an 84-year-old male with CIDP, maintained on biweekly IVIG infusions, who experienced a syncopal episode with documented bradycardia of 30 beats per minute (bpm) during an infusion. Upon evaluation in the emergency department, the patient was found to have a new bifascicular block requiring pacemaker placement. This case underscores a rare adverse reaction associated with IVIG infusion, highlighting the importance of careful cardiac monitoring in older patients with CIDP and underlying or potential cardiac risk factors.

摘要

慢性炎症性脱髓鞘性多发性神经病(CIDP)是一种免疫介导的神经病,常采用静脉注射免疫球蛋白(IVIG)治疗,该治疗通常耐受性良好,但偶尔会出现罕见的心血管副作用。我们报告一例84岁男性CIDP患者,每两周接受一次IVIG输注,在一次输注过程中发生晕厥,记录到心率每分钟30次(bpm)的心动过缓。在急诊科评估时,发现该患者出现新的双分支阻滞,需要植入起搏器。该病例强调了与IVIG输注相关的一种罕见不良反应,突显了对患有CIDP且有潜在心脏危险因素的老年患者进行仔细心脏监测的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ca4/12065474/56cf0fbd5805/cureus-0017-00000082010-i01.jpg

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