rss
Ann Rheum Dis 2000;59:77 doi:10.1136/ard.59.1.77
  • Concise report

Acute myocardial infarction associated with high dose intravenous immunoglobulin infusion for autoimmune disorders. A study of four cases

  1. Ori Elkayama,
  2. Daphna Parana,
  3. Ronny Milob,
  4. Yaron Davidovitzc,
  5. Dorit Almoznino-Sarafiand,
  6. David Zeltsere,
  7. Michael Yarona,
  8. Dan Caspia
  1. aDepartment of Rheumatology, Tel Aviv “Sourasky” Medical Centre, Israel, bDepartment of Neurology, Assaf Harofeh Medical Centre, Israel, cDepartment of Haematology, E Wolfson Medical Centre, Israel, dDepartment of Medicine F, Assaf Harofeh Medical Centre, Israel, eDepartment of Medicine, Tel Aviv “Sourasky” Medical Centre, Israel
  1. Dr O Elkayam, Department of Rheumatology, Tel Aviv “Sourasky” Medical Centre, 6 Weizman Street, Tel Aviv 64329, Israel.
  • Accepted 12 August 1999

Abstract

OBJECTIVE To report on four patients with autoimmune disorders who developed acute myocardial infarction (MI) during or soon after treatment with high dose intravenous immunoglobulins (IVIG) and to determine the clinical profile of patients prone to this complication.

METHODS The clinical history of the four patients is reported with details concerning age, sex, indication for IVIG treatment, risk factors, timing of the MI and outcome. The relevant medical literature has been reviewed.

RESULTS The patients, three men and one woman, aged 42–67, received IVIG treatment for different autoimmune disorders. All had a history of atherosclerosis or previous risk factors such as hypertension, stroke, hyperlipidaemia and obesity. Two of the patients suffered a MI after the first infusion of IVIG while the others—after the 5th and 15th pulses. MI occurred during the infusion in two patients and after a few days in the others. All the patients recovered from the acute event. These observations are in concert with sporadic cases of IVIG related thrombosis reported in the medical literature.

CONCLUSION In patients with vascular risk factors such as old age, hypertension, history of stroke or coronary artery disease, the possibility of IVIG related vascular complications should be considered and IVIG prescribed with a cautious reweighted risk/benefit consideration.

Footnotes

    This Article

    1. Abstract
    2. Full text
    3. PDF

    Responses

    1. Submit a response
    2. No responses published

    Register for free content

    The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

    Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.