Effect of high-dose intravenous immunoglobulin therapy on blood rheology

Successful Treatment of Adult-onset Henoch-Schoenlein Purpura Nephritis with High-dose Immunoglobulins.

“…Therefore renal function should be closely monitored after IV-IG. These adverse effects of IV-IG are suggested to be induced by the rise in viscosity and thromboemboli (20). In our case, there wasno adverse effect of IV-IG under anti-coagulant therapy.…”

Acute ST elevation myocardial infarction after intravenous immunoglobulin infusion in a young patient: a rare but probable adverse effect of immunoglobulin

“…Proposed mechanisms consist of platelet or endothelial cell activation and increased blood viscosity, which is a significant determinant of subendocardial oxygen delivery. 9,10 Reductions in IVIG doses and administration at lower infusion rates may be advisable for patients with underlying cardiovascular disease or those who experience anginal symptoms during or after IVIG infusion. Manufacturer guidelines strongly recommend that when there is a potential risk of a thrombotic event, the concentration of IVIG should not exceed 5%, the infusion should be initiated at a rate of 0.5 mL/kg/hr, and the infusion rate should be increased slowly to a maximum of 4 mL/kg/hr as tolerated.…”

Chronic Relapsing Thrombotic Thrombocytopenic Purpura

“…Because VWF has an important role in the pathogenesis of CRTTP, as indicated by the authors, and because of the increased plasma and blood viscosity seen with IV administration of immune globulin, as shown by Reinhart and Berchtold [7], I believe that these treatments may have increased the attacks observed twice in our patient during corticosteroid administration.…”