A case of deep vein thrombosis and pulmonary thromboembolism after intravenous immunoglobulin therapy

• Published in: Journal of Korean medical science Vol. 22; no. 4; pp. 758 - 761
• Main Authors: Lee, Yu Ji, Shin, Jae Uk, Lee, Jeeyun, Kim, Kihyun, Kim, Won Seog, Ahn, Jin Seok, Jung, Chul Won, Kang, Won Ki
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01-08-2007
• Subjects: Case Report; Female; Humans; Immunoglobulins, Intravenous - adverse effects; Immunoglobulins, Intravenous - therapeutic use; Middle Aged; Pulmonary Embolism - chemically induced; Purpura, Thrombocytopenic, Idiopathic - drug therapy; Venous Thrombosis - chemically induced
• ISSN: 1011-8934; 1598-6357
• DOI: 10.3346/jkms.2007.22.4.758

Although high-dose intravenous immunoglobulin (IVIG) is generally considered a safe medication for various immune-mediated diseases, thrombotic events have been reported as a complication of the therapy. We report a case who developed thrombotic complications after receiving IVIG. A 56-yr-old woman with idiopathic thrombocytopenic purpura received IVIG at a dose of 400 mg/kg/day for five days. Three days after the administration of IVIG, the patient developed painful edema in the left leg. Lower extremity doppler ultrasound revealed deep vein thrombosis in the left leg. Chest computed tomography (CT) scan demonstrated a filling defect indicating thromboembolism of the right pulmonary artery. After three weeks of enoxaparin therapy, her symptoms and pulmonary embolism on CT improved. This case suggests clinicians should be cautious in the development of thromboembolism by administration of IVIG, especially in patients with thrombophilia.