Main Article

Hemolytic anemia associated with intravenous immunoglobulin

  1. John R. Wilson MD1,*,
  2. Nirmala Bhoopalam MD2,
  3. Morris Fisher MD1

Article first published online: 7 DEC 1998

DOI: 10.1002/(SICI)1097-4598(199709)20:9<1142::AID-MUS8>3.0.CO;2-8

Issue

Muscle & Nerve

Muscle & Nerve

Volume 20, Issue 9, pages 1142–1145, September 1997

Additional Information

How to Cite

Wilson, J. R., Bhoopalam, N. and Fisher, M. (1997), Hemolytic anemia associated with intravenous immunoglobulin. Muscle & Nerve, 20: 1142–1145. doi: 10.1002/(SICI)1097-4598(199709)20:9<1142::AID-MUS8>3.0.CO;2-8

Author Information

  1. 1

    Department of Neurology #127, Hines VA Hospital, Hines, IL 60141, USA

  2. 2

    Department of Hematology and Oncology #111B, Hines VA Hospital, Hines, IL 60141, USA

*Department of Neurology #127, Hines VA Hospital, Hines, IL 60141, USA

Publication History

  1. Issue published online: 7 DEC 1998
  2. Article first published online: 7 DEC 1998
  3. Manuscript Accepted: 20 APR 1997
  4. Manuscript Received: 11 SEP 1996

Funded by

  • Hines VA Hospital

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Keywords:

  • intravenous immunoglobulin;
  • autoimmune disease;
  • hemolytic anemia;
  • peripheral neuropathy;
  • neuromuscular disorders

Abstract

Intravenous immunoglobulin (IVIg) is a useful tool in the treatment of a variety of neuromuscular disorders. Though IVIg therapy is generally safe, hemolytic anemia is a potentially serious complication that is often overlooked, and is currently not listed in product inserts. We analyzed 45 patients who received IVIg therapy, including 38 consecutive patients who received IVIg over a 13-month period. On 42 patients, direct antiglobulin testing was performed, searching for antibodies to the patients' own blood type. Of these 42 patients, 12 developed passive sensitization with antibodies to their own blood group antigens after receiving IVIg. Of these 12 patients, 11 patients developed hemolysis severe enough to lower the hemoglobin level by at least 1 g/dL. Of these patients, 3 required blood transfusion, and 1 had IVIg therapy truncated because of the hemolysis. Antibodies to blood group antigens are found in all commercial preparations of IVIg. Though most patients do not have clinically significant hemolysis, clinicians should be aware of this potentially serious complication. Careful monitoring of hemoglobin levels during IVIg therapy is recommended. © 1997 John Wiley & Sons, Inc. Muscle Nerve 20:1142–1145, 1997

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