PMID- 12749010
OWN - NLM
STAT- MEDLINE
DCOM- 20030620
LR  - 20041117
IS  - 0361-8609 (Print)
IS  - 0361-8609 (Linking)
VI  - 73
IP  - 2
DP  - 2003 Jun
TI  - Intravenous immunoglobulin therapy results in post-infusional hyperproteinemia, 
      increased serum viscosity, and pseudohyponatremia.
PG  - 97-100
AB  - Intravenous immunoglobulin (IVIG) therapy is associated with rare reports of 
      thromboembolic events and severe hyponatremia. We hypothesized that IVIG therapy 
      may result in hyperproteinemia, increased serum viscosity, and 
      pseudohyponatremia. We conducted a prospective observational study to evaluate 
      the incidence of hyperproteinemia occurring after IVIG therapy and its 
      relationship to serum sodium, viscosity, osmolality, and the serum osmolar gap. 
      Eighteen IVIG infusions at a standard dose of 2 g/kg administered over 2-5 days 
      were evaluated. Serum glucose, sodium, protein, viscosity, osmolality, and a 
      calculated osmolar gap were obtained prior to therapy, 6 hr after the initiation 
      of therapy, 24 hr after the conclusion of therapy, and on post-treatment day 10. 
      Paired t-testing revealed a statistically significant increase in serum protein 
      and viscosity and decrease in serum sodium and calculated osmolality 24 hr after 
      the completion of IVIG therapy. The calculated serum osmolar gap increased 
      insignificantly. In multivariate analysis, hyperproteinemia at the 6-hr time 
      point predicted hyponatremia (P < 0.000), and hyperproteinemia at the 24-hr time 
      point predicted both hyponatremia and increased serum viscosity (P = 0.024). 
      These data demonstrate that increased serum viscosity occurs following IVIG 
      therapy due to hyperproteinemia, and the rare hyponatremia reported is a 
      pseudohyponatremia also due to hyperproteinemia.
FAU - Steinberger, Beth A
AU  - Steinberger BA
AD  - Department of Internal Medicine, Dwight D. Eisenhower Army Medical Center, 
      Augusta, Georgia, USA.
FAU - Ford, Stephen M
AU  - Ford SM
FAU - Coleman, Teresa A
AU  - Coleman TA
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Hematol
JT  - American journal of hematology
JID - 7610369
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
MH  - Blood Viscosity/*drug effects
MH  - Female
MH  - Humans
MH  - Hyperprolactinemia/*blood/*chemically induced
MH  - Hyponatremia/*blood/*chemically induced
MH  - Immunoglobulins, Intravenous/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Pulmonary Embolism/chemically induced
EDAT- 2003/05/16 05:00
MHDA- 2003/06/21 05:00
CRDT- 2003/05/16 05:00
PHST- 2003/05/16 05:00 [pubmed]
PHST- 2003/06/21 05:00 [medline]
PHST- 2003/05/16 05:00 [entrez]
AID - 10.1002/ajh.10325 [doi]
PST - ppublish
SO  - Am J Hematol. 2003 Jun;73(2):97-100. doi: 10.1002/ajh.10325.