PMID- 19628320
OWN - NLM
STAT- MEDLINE
DCOM- 20100202
LR  - 20101118
IS  - 1523-6838 (Electronic)
IS  - 0272-6386 (Linking)
VI  - 55
IP  - 1
DP  - 2010 Jan
TI  - Hemoglobinuria and acute kidney injury requiring hemodialysis following 
      intravenous immunoglobulin infusion.
PG  - 148-51
LID - 10.1053/j.ajkd.2009.06.013 [doi]
AB  - Intravenous immunoglobulin (IVIG), a product initially developed for patients 
      with immunodeficiencies, now has multiple other indications and increasing 
      off-label use. IVIG generally is well tolerated, with few adverse effects. 
      Antibody-mediated (Coombs-positive) hemolysis is known to occur after IVIG 
      infusion, but often is subclinical and previously has not been reported to lead 
      to acute kidney injury (AKI). The predominantly known mechanism of AKI after IVIG 
      infusion has been osmotic nephrosis, primarily associated with sucrose-containing 
      formulations. We present a case of a bone marrow transplant recipient who was 
      treated with a sucrose-free IVIG product and subsequently developed 
      Coombs-positive hemolysis leading to AKI requiring hemodialysis, who ultimately 
      died secondary to infectious complications. The severity of this case emphasizes 
      the importance of identifying populations who may be at increased risk of 
      pigment-mediated kidney injury before consideration of IVIG therapy.
CI  - Copyright 2009 National Kidney Foundation, Inc. Published by Elsevier Inc. All 
      rights reserved.
FAU - Welles, Christine C
AU  - Welles CC
AD  - Division of Internal Medicine, Stanford University, Stanford, CA 94305-5114, USA.
FAU - Tambra, Shouieb
AU  - Tambra S
FAU - Lafayette, Richard A
AU  - Lafayette RA
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20090723
PL  - United States
TA  - Am J Kidney Dis
JT  - American journal of kidney diseases : the official journal of the National Kidney 
      Foundation
JID - 8110075
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Immunologic Factors)
SB  - IM
MH  - Acute Kidney Injury/*chemically induced/therapy
MH  - Bone Marrow Transplantation/adverse effects
MH  - Fatal Outcome
MH  - Female
MH  - Follow-Up Studies
MH  - Graft vs Host Disease/drug therapy
MH  - Hemoglobinuria/*chemically induced/therapy
MH  - Humans
MH  - Immunoglobulins, Intravenous/administration & dosage/*adverse effects
MH  - Immunologic Factors/administration & dosage/*adverse effects
MH  - Infusions, Intravenous
MH  - Middle Aged
MH  - Renal Dialysis/*methods
EDAT- 2009/07/25 09:00
MHDA- 2010/02/03 06:00
CRDT- 2009/07/25 09:00
PHST- 2009/02/19 00:00 [received]
PHST- 2009/06/08 00:00 [accepted]
PHST- 2009/07/25 09:00 [entrez]
PHST- 2009/07/25 09:00 [pubmed]
PHST- 2010/02/03 06:00 [medline]
AID - S0272-6386(09)00876-2 [pii]
AID - 10.1053/j.ajkd.2009.06.013 [doi]
PST - ppublish
SO  - Am J Kidney Dis. 2010 Jan;55(1):148-51. doi: 10.1053/j.ajkd.2009.06.013. Epub 
      2009 Jul 23.