PMID- 9138386
OWN - NLM
STAT- MEDLINE
DCOM- 19970520
LR  - 20101118
IS  - 0040-5957 (Print)
IS  - 0040-5957 (Linking)
VI  - 51
IP  - 5
DP  - 1996 Sep-Oct
TI  - [Acute kidney failure secondary to intravenous immunoglobulin administration. 4 
      cases and review of the literature].
PG  - 516-26
AB  - Intravenous immunoglobulin (IVIG) is currently used for an increasing number of 
      indications where an immune-medicated disorder is suspected. It is considered as 
      a safe and efficacious treatment but several cases of severe acute renal failure 
      (ARF) have been described since 1987. We report four cases of IVIG-induced ARF 
      and the literature on the subject is reviewed. The chronological and semiological 
      characteristics of this rare adverse effect are analysed. A sudden and marked 
      increase of serum creatinine within the 2 to 4 days following institution of IVIG 
      therapy, especially when the patient becomes oligo-anuric, is very suggestive of 
      IVIG renal toxicity. The recovery of renal function is often obtained in 10 to 15 
      days after discontinuation of the drug. Histological changes are characterized by 
      osmotic nephrosis injuries. Patients generally presented numerous risk factors 
      such as over 65 years, particularly in men, pre-existing renal disease, 
      long-standing diabetes mellitus or hypertension, volume depletion, quick infusion 
      rate, body-weight adjustment of IVIG doses in fat subjects. The mechanism of 
      renal injury remains speculative but an oncotic overloading of kidney probably 
      occurs. These results indicate the need for research and investigation of risk 
      factors before starting IVIG therapy. Close monitoring of serum creatinine and 
      diuresis should be carried out during and after treatment.
FAU - Decocq, G
AU  - Decocq G
AD  - Centre regional de Pharmacovigilance, CHU Hopital Sud, Amiens, France.
FAU - de Cagny, B
AU  - de Cagny B
FAU - Andrejak, M
AU  - Andrejak M
FAU - Desablens, B
AU  - Desablens B
LA  - fre
PT  - Case Reports
PT  - English Abstract
PT  - Journal Article
PT  - Review
TT  - Insuffisance renale aigue secondaire a l'administration d'immunoglobulines 
      intraveineuses. Quatre observations et revue de la litterature.
PL  - France
TA  - Therapie
JT  - Therapie
JID - 0420544
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
MH  - Acute Kidney Injury/*chemically induced/physiopathology
MH  - Adult
MH  - Aged
MH  - Female
MH  - Humans
MH  - Immunoglobulins, Intravenous/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Risk Factors
RF  - 26
EDAT- 1996/09/01 00:00
MHDA- 1996/09/01 00:01
CRDT- 1996/09/01 00:00
PHST- 1996/09/01 00:00 [pubmed]
PHST- 1996/09/01 00:01 [medline]
PHST- 1996/09/01 00:00 [entrez]
PST - ppublish
SO  - Therapie. 1996 Sep-Oct;51(5):516-26.