Neutropenia as a complication of intravenous immunoglobulin (IVIG) therapy in children with immune thrombocytopenic purpura: common and non-alarming

Neutropenia Following Intravenous Immunoglobulin Administration in a Patient with Multifocal Motor Neuropathy with Conduction Block

“…In the present case, neutropenia developed on day 2 after initiation of infusion and reached nadir on day 4. In line with previous reports [8,10], leukocyte counts of our patient returned to baseline after 2 weeks without any complication.…”

“…Neutropenia following IVIG was initially recognized in patients with idiopathic thrombocytopenia purpura [7,8]. Ben-Chetrit et al [9] reported a patient with active systemic lupus erythematosus who received two courses of IVIG infusion.…”

Immunologic and functional evidence for anti–Siglec-9 autoantibodies in intravenous immunoglobulin preparations

“…On the other hand, the reason for IVIg-induced neutropenia in some patients remains obscure, [31][32][33][34][35] and the results of our study may also provide a potential mechanism of this unwanted effect of IVIg therapy. In particular, under inflammatory conditions, IVIg-induced neutropenia may be mediated by natural anti-Siglec-9 autoantibodies.…”

Intravenous immunoglobulins contain naturally occurring antibodies that mimic antineutrophil cytoplasmic antibodies and activate neutrophils in a TNFα-dependent and Fc-receptor–independent way

“…Despite considerable improvements in the generation of IVIg preparations, a variety of adverse effects have been reported. [9][10][11][12][13][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]41,[54][55][56] Some of these side effects have been ascribed to the low content of IgG oligomers (aggregates) and dimers in the preparations that increase upon storage. Activation of the respiratory burst, generation of PAF, and degranulation of neutrophils can be triggered by IgG dimers and oligomers via Fc␥ RIIa receptors 57,58 without complexation to antigens and are thus believed to trigger some of the known clinical side effects.…”