Thromboembolic risk with IVIg: Incidence and risk factors in patients with inflammatory neuropathy

Neurology. 2020 Feb 11;94(6):e635-e638. doi: 10.1212/WNL.0000000000008742. Epub 2019 Dec 18.

Abstract

Our objective was to evaluate whether IV immunoglobulin (IVIg) increases the risk of thromboembolic events in neurology outpatients with inflammatory neuropathies, as there is conflicting evidence supporting this hypothesis, mainly from non-neurologic cohorts. We investigated this question over 30 months in our cohort of patients with inflammatory neuropathies receiving regular IVIg and found a greater incidence of arterial and venous thromboembolic events than population-based rates determined by hospital admissions data. Vascular risk factors were more common in the event group but there were no IVIg administration factors that contributed to the risk. This study suggests that IVIg may have a small but contributory role in determining thromboembolic risk in the inflammatory neuropathy cohort and more evidence is required before it is clear whether the current primary prevention guidelines are appropriate in this group of patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anemia, Hemolytic, Autoimmune / therapy
  • Ataxia / therapy
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use*
  • Immunologic Factors / therapeutic use*
  • Incidence
  • Myocardial Infarction / epidemiology
  • Ophthalmoplegia / therapy
  • Polyneuropathies / therapy*
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / therapy*
  • Pulmonary Embolism / epidemiology
  • Retrospective Studies
  • Risk Factors
  • Small Fiber Neuropathy / therapy
  • Stroke / epidemiology
  • Superior Vena Cava Syndrome / epidemiology
  • Thromboembolism / epidemiology*
  • Venous Thrombosis / epidemiology

Substances

  • Immunoglobulins, Intravenous
  • Immunologic Factors

Supplementary concepts

  • CANOMAD syndrome