Occurrence of hemolytic anemia in patients with GBS treated with high-dose IVIg.

Autor(es): Nguyen Thy P.; Biliciler Suur; Wahed Amer; Sheikh Kazim

Resumo: We describe an underrecognized side effect of high-dose IV immunoglobulin (IVIg), hemolytic anemia. 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. 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. All patients with non-O blood types developed clinically significant hemolytic anemia requiring blood transfusion. Hemolytic anemia may limit doses of IVIg for treatment of severe GBS in patients with non-O blood types.

Imprenta: Neurology Neuroimmunology & Neuroinflammation, v. 1, n. 4, p. 50, 2014

Identificador do objeto digital: 10.1212/NXI.0000000000000050

Descritores: Guillain-Barre Syndrome - Cytopathology

Data de publicação: 2014