RT Journal Article
SR Electronic
T1 Occurrence of hemolytic anemia in patients with GBS treated with high-dose IVIg
JF Neurology - Neuroimmunology Neuroinflammation
JO Neurol Neuroimmunol Neuroinflamm
FD Lippincott Williams & Wilkins
SP e50
DO 10.1212/NXI.0000000000000050
VO 1
IS 4
A1 Thy P. Nguyen
A1 Suur Biliciler
A1 Amer Wahed
A1 Kazim Sheikh
YR 2014
UL http://nn.neurology.org/content/1/4/e50.abstract
AB Objective: We describe an underrecognized side effect of high-dose IV immunoglobulin (IVIg), hemolytic anemia.Background: There are no established guidelines on treating patients with Guillain-Barré syndrome (GBS) who relapse or do not improve after a standard course of treatment (IVIg or plasma exchange). Some centers will opt for a second course of the initial treatment. There is an ongoing trial of a second course of IVIg in patients with severe GBS.Methods: We retrospectively reviewed 4 patients with severe GBS who received high-dose IVIg. One patient inadvertently received a high dose of IVIg for Miller Fisher syndrome. All patients received a total of at least 2 courses of the standard dose of IVIg (total >4 g/kg). We review their clinical course and side effects.Results: All patients with non-O blood types developed clinically significant hemolytic anemia requiring blood transfusion.Conclusion: Hemolytic anemia may limit doses of IVIg for treatment of severe GBS in patients with non-O blood types.GBS=Guillain-Barré syndrome; HA=hemolytic anemia; IVIg=IV immunoglobulin; MFS=Miller Fisher syndrome