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Intravenous immunoglobulin(IVIg)is advocated as a safe treatment for immune-mediated neurologic disease.We reviewed the medical records of 88 patients who were given IVIg for a neurologic illness.Major complications in four patients(4.5%)included congestive heart failure in a patient with polymyositis,hypotension after a recent myocardial infarction,deep venous thrombosis in a bed-bound patient,and acute renal failure with diabetic nephropathy.Other adverse affects included vasomotor symptoms 26,headache 23,rash 5,leukopenia 4,fever 3,neutropenia 1,proteinuria(1.9 g/day)1,viral syndrome 1,dyspnea 1,and pruritis 1.Fifty-two patient(59%)had some adverse effect of IVIg infusion,most commonly vasomotor symptoms,headaches,fever, or shortness of breath in 40(45%),which improved with reduced infusion rate or symptomatic medications.Five(6%)had asymptomatic laboratory abnormalities and seven(8%)had other minor adverse effects.Adverse effects led to discontinuation of therapy in 16%and permanent termination of therapy in 10%of patients.There was no mortality or long-term morbidity. Although adverse effects were frequent,serious complications were rare except in patients with heart disease,renal insufficiency,and bed-bound state. |
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