PMID- 26720165
OWN - NLM
STAT- MEDLINE
DCOM- 20180621
LR  - 20180621
IS  - 1536-3686 (Electronic)
IS  - 1075-2765 (Linking)
VI  - 24
IP  - 6
DP  - 2017 Nov/Dec
TI  - Immune Modulatory Therapy Causing Acute Coronary Syndrome.
PG  - e689-e692
LID - 10.1097/MJT.0000000000000373 [doi]
AB  - Intravenous immunoglobulin (IVIG) is a therapeutic preparation of pooled 
      polyspecific IgG used effectively in immune thrombocytopenic purpura (ITP), 
      autoimmune diseases, and inflammatory diseases. We present a case of a 
      67-year-old male who presented with diffuse petechiae and was diagnosed with 
      immune thrombocytopenic purpura with platelet count less than 10,000 per 
      milliliter. Treatment was initiated with IVIG. When the third dose of IVIG was 
      being administered he developed hypertensive urgency and non-ST segment elevation 
      myocardial infarction. He was deemed not to be a candidate for cardiac 
      catheterization and was treated conservatively. IVIG can cause major thrombotic 
      adverse events such as deep vein thrombosis, myocardial infarction and stroke, 
      which are attributed to thrombosis and hyperviscocity. Decreasing the dosage of 
      IVIG, administration of anticoagulants are proposed treatments for such events. 
      We propose that patients receiving high-dose IVIG with previous coronary artery 
      disease require meticulous cardiac monitoring. Further research is needed to 
      determine the true adverse effects of high-dose IVIG and prophylaxis regimens to 
      decrease the risk.
FAU - Agrawal, Yashwant
AU  - Agrawal Y
AD  - 1Department of Internal Medicine & Pediatrics, Western Michigan University Homer 
      Stryker M.D. School of Medicine, Kalamazoo, MI; 2Department of Internal Medicine, 
      Michigan State University, Lansing, MI; and 3Department of Cardiology, Borgess 
      Medical Center, Kalamazoo, MI.
FAU - Jacob, Chris
AU  - Jacob C
FAU - Demchuk, Nathan
AU  - Demchuk N
FAU - Tikaria, Richa
AU  - Tikaria R
FAU - Virupannavar, Shanti
AU  - Virupannavar S
FAU - Khajuria, Bhavik
AU  - Khajuria B
FAU - Kalavakunta, Jagadeesh K
AU  - Kalavakunta JK
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Am J Ther
JT  - American journal of therapeutics
JID - 9441347
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Immunologic Factors)
SB  - IM
MH  - Acute Coronary Syndrome/blood/*chemically induced/diagnosis/drug therapy
MH  - Aged
MH  - Antihypertensive Agents/therapeutic use
MH  - Dose-Response Relationship, Drug
MH  - Electrocardiography
MH  - Humans
MH  - Hypertension/blood/*chemically induced/diagnosis/drug therapy
MH  - Immunoglobulins, Intravenous/*adverse effects
MH  - Immunologic Factors/*adverse effects
MH  - Male
MH  - Platelet Count
MH  - Purpura, Thrombocytopenic, Idiopathic/blood/*drug therapy/immunology
MH  - Tomography, X-Ray Computed
EDAT- 2016/01/01 06:00
MHDA- 2018/06/22 06:00
CRDT- 2016/01/01 06:00
PHST- 2016/01/01 06:00 [pubmed]
PHST- 2018/06/22 06:00 [medline]
PHST- 2016/01/01 06:00 [entrez]
AID - 10.1097/MJT.0000000000000373 [doi]
PST - ppublish
SO  - Am J Ther. 2017 Nov/Dec;24(6):e689-e692. doi: 10.1097/MJT.0000000000000373.