PMID- 18219840
OWN - NLM
STAT- MEDLINE
DCOM- 20080219
LR  - 20080128
IS  - 1081-1206 (Print)
IS  - 1081-1206 (Linking)
VI  - 99
IP  - 6
DP  - 2007 Dec
TI  - Myocardial infarction during intravenous immunoglobulin infusion in a 65-year-old 
      man with common variable immunodeficiency and subsequent successful repeated 
      administration.
PG  - 567-70
LID - 10.1016/S1081-1206(10)60388-2 [doi]
AB  - BACKGROUND: Intravenous immunoglobulin (IVIG) may cause thromboembolic events. 
      Although such events are usually associated with large IVIG doses administered to 
      treat neurologic diseases, thromboembolic events may also occur with standard 
      immunodeficiency doses. OBJECTIVE: We describe a 65-year-old man with common 
      variable immunodeficiency (CVID) who experienced angina and myocardial infarction 
      with IVIG infusion. METHODS: The patient's electronic medical record was 
      reviewed. RESULTS: The patient developed substernal chest pain during a scheduled 
      40-g (400-mg/kg) infusion. The infusion was discontinued, and a cardiac 
      evaluation was initiated. The patient was found to have elevated troponin T and 
      creatine kinase MB levels, signifying cardiac injury. Heart catheterization 
      revealed severe vessel disease, and surgical revascularization was subsequently 
      performed. Three weeks after revascularization, an IVIG dose of 200 mg/kg was 
      cautiously readministered. This dose was increased in 2 weeks to 300 mg/kg, which 
      was tolerated every 3 to 4 weeks without any adverse thrombotic events in the 
      subsequent 12 months. CONCLUSIONS: This case demonstrates not only angina and 
      myocardial infarction associated with IVIG infusion in a patient with CVID but 
      also the successful reinitiation of IVIG infusion after surgical 
      revascularization. This case also underscores the importance of caution with IVIG 
      infusion in patients with CVIDand known coronary artery disease.
FAU - Dave, Shoban
AU  - Dave S
AD  - Division of Allergic Diseases, Department of Medicine. Mayo Clinic, Rochester, 
      Minnesota 55905, USA. dave.shoban@mayo.edu
FAU - Hagan, John
AU  - Hagan J
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Ann Allergy Asthma Immunol
JT  - Annals of allergy, asthma & immunology : official publication of the American 
      College of Allergy, Asthma, & Immunology
JID - 9503580
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
MH  - Aged
MH  - Common Variable Immunodeficiency/*therapy
MH  - Humans
MH  - Immunoglobulins, Intravenous/*adverse effects/therapeutic use
MH  - Male
MH  - Myocardial Infarction/*chemically induced/therapy
MH  - Myocardial Revascularization
EDAT- 2008/01/29 09:00
MHDA- 2008/02/20 09:00
CRDT- 2008/01/29 09:00
PHST- 2008/01/29 09:00 [pubmed]
PHST- 2008/02/20 09:00 [medline]
PHST- 2008/01/29 09:00 [entrez]
AID - S1081-1206(10)60388-2 [pii]
AID - 10.1016/S1081-1206(10)60388-2 [doi]
PST - ppublish
SO  - Ann Allergy Asthma Immunol. 2007 Dec;99(6):567-70. doi: 
      10.1016/S1081-1206(10)60388-2.