Cerebral infarctions after intravenous immunoglobulin therapy for ITP in a child

Pediatr Neurol. 2014 Feb;50(2):188-91. doi: 10.1016/j.pediatrneurol.2013.09.013. Epub 2013 Sep 27.

Abstract

Background: Intravenous immunoglobulin is the favored therapy in childhood immune thrombocytopenic purpura. It is usually well tolerated with manageable side effects, but venous and arterial thrombosis following its administration have been described, mostly in adults.

Methods: We describe a 3-year-old girl with immune thrombocytopenic purpura and intracranial hemorrhage who received intravenous immunoglobulin therapy and subsequently developed multifocal cerebral infarctions.

Results: Product specific as well as other factors may play a role in the development of this complication of intravenous immunoglobulin therapy. This is the only reported case of intravenous immunoglobulin-related thrombosis in a child with immune thrombocytopenic purpura and intracranial hemorrhage.

Conclusions: Thrombotic complications are associated with intravenous immunoglobulin administration and this includes cerebral infarcts.

Keywords: cerebral infarcts; immune thrombocytopenia; intracranial hemhorrage; intravenous immnunoglobulin.

Publication types

  • Case Reports

MeSH terms

  • Brain / diagnostic imaging
  • Brain / pathology
  • Brain / physiopathology
  • Cerebral Infarction / etiology*
  • Cerebral Infarction / pathology
  • Child, Preschool
  • Diffusion Magnetic Resonance Imaging
  • Evoked Potentials, Visual
  • Female
  • Humans
  • Immunoglobulins, Intravenous / adverse effects*
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunologic Factors / adverse effects*
  • Immunologic Factors / therapeutic use
  • Intracranial Hemorrhages / complications
  • Intracranial Hemorrhages / pathology
  • Intracranial Hemorrhages / therapy
  • Magnetic Resonance Imaging
  • Purpura, Thrombocytopenic, Idiopathic / complications
  • Purpura, Thrombocytopenic, Idiopathic / pathology
  • Purpura, Thrombocytopenic, Idiopathic / therapy
  • Tomography, X-Ray Computed

Substances

  • Immunoglobulins, Intravenous
  • Immunologic Factors