VI nerve palsy after intravenous immunoglobulin in Kawasaki disease

Rodríguez-Lozano, Ana Luisa; Rivas-Larrauri, Francisco; Gámez-González, Luisa Berenise; Yamazaki‐Nakashimada, Marco Antonio

doi:10.1016/j.aller.2012.08.003

Cited by 8 publications

(6 citation statements)

References 13 publications

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“…The patient recovered completely after 2 weeks, and aseptic meningitis was considered the underlying cause. Furthermore, two case reports described patients with Kawasaki disease who developed abducens nerve palsy after IVIG therapy ( 74 , 75 ). However, whether abducens nerve palsy was directly related to immunoglobulin therapy in these cases is unclear.…”

Section: Classification Of Adverse Effectsmentioning

confidence: 99%

Adverse Effects of Immunoglobulin Therapy

et al. 2018

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Immunoglobulin has been widely used in a variety of diseases, including primary and secondary immunodeficiency diseases, neuromuscular diseases, and Kawasaki disease. Although a large number of clinical trials have demonstrated that immunoglobulin is effective and well tolerated, various adverse effects have been reported. The majority of these events, such as flushing, headache, malaise, fever, chills, fatigue and lethargy, are transient and mild. However, some rare side effects, including renal impairment, thrombosis, arrhythmia, aseptic meningitis, hemolytic anemia, and transfusion-related acute lung injury (TRALI), are serious. These adverse effects are associated with specific immunoglobulin preparations and individual differences. Performing an early assessment of risk factors, infusing at a slow rate, premedicating, and switching from intravenous immunoglobulin (IVIG) to subcutaneous immunoglobulin (SCIG) can minimize these adverse effects. Adverse effects are rarely disabling or fatal, treatment mainly involves supportive measures, and the majority of affected patients have a good prognosis.

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Section: Classification Of Adverse Effectsmentioning

confidence: 99%

Adverse Effects of Immunoglobulin Therapy

et al. 2018

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“…Due to the low number of case reports, we could not safely conclude that abducens nerve palsy was associated with greater disease severity. [54][55][56][57] Sensorineural hearing loss has also been reported in children with Kawasaki disease and usually appears in the first days of the disease. 58 The mechanism of this complication is not clear, but it could be the result of aseptic inflammation of the vestibulocochlear nerve.…”

Section: Other Cranial Nervesmentioning

confidence: 98%

“…In general, most authors agree that neurological complications in Kawasaki disease reflect an increased underlying inflammatory burden. 10,13 15 Ishida et al, 26 Sabatier et al, 16 Yamazaki-Nakashimada et al, 25 Wang et al, 17 Ahn et al, 24 Tanaka et al, 28 Wada et al, 22 Du et al, 27 Suda et al, 18 Hoshino et al, 29 Fujiwara et al, 19 Laxer et al, 20 51 Stowe, 50 Khubchandani and Dhanrajani, 49 Kocabas et al, 48 Thapa, 47 Kaur et al, 46 Lim et al, 45 Li et al, 43 Wright et al, 44 Larralde et al, 42 Poon et al 52 Abducens nerve palsy 4 (case reports) Emiroglu et al, 54 Rodriguez-Lozano et al, 55 Guven et al, 56 Wurzburger et al 57 Articles identified by our literature search consisted mostly of case reports or case series. Prospective and retrospective studies are uncommon and can be attributed to the relative rarity of neurological complications in this entity.…”

Section: Neurological Manifestationsmentioning

confidence: 99%

Involvement of Nervous System in Kawasaki Disease

Γώγου

Giannopoulos

2017

J Pediatr Neurol

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The aim of this study was to summarize the published reports about neurological manifestations of Kawasaki disease and underlying mechanisms. PubMed was used as the source for medical database. The prevalence of neurological complications is estimated to range from 1.1 to 3.7% and can include strokes, inflammation of central nervous system, dysfunction of cranial nerves, behavioral disorders as well as syndrome of inappropriate antidiuretic hormone secretion. Their incidence is usually associated with an increased risk for coronary artery aneurysms. In particular, the involvement of facial nerve seems to be a marker of disease severity. Although prognosis is generally remarkable, serious complications may arise in some cases. The early initiation of appropriate therapy prevents the appearance of neurological manifestations in children with Kawasaki disease.

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“…Although his brain MRI was normal, fluorescein angiography revealed findings suggestive of vasculitis. Oral prednisone was given, and the palsy disappeared 2 weeks later [4]. A 7-year-old girl with classic KD with coronary involvement was described by Wurzburger et al [5].…”

mentioning

confidence: 94%

“…Although the ischemic effects of vasculitis on arteries supplying nerves has been predicted to be a major factor in cranial nerve palsies [5], it can be due to primary cranial nerve neuritis [6] or perineuritis due to adjacent meningeal inflammatory reaction [4] or compression effect of the increased intracranial pressure in patients with pseudotumor cerebri or cerebral edema. Recently, Rodríguez-Lozano et al [4] argued that ANP could be associated with high-dose IVIG treatment based on an adult patient with kidney transplantation who had experienced aseptic meningitis and ANP 2 days after high-dose IVIG treatment. Also, in the majority (71.4 %) of patients with facial paralysis, it generally develops after IVIG transfusion [1].…”

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confidence: 99%

Abducens nerve palsy in a girl with incomplete Kawasaki disease

2016

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Kawasaki disease (KD) is a systemic vasculitis that can involve the nervous system, including the cranial nerves. Central nervous system findings, especially irritability, lethargy, and aseptic meningitis, occur in 1-30 % of KD patients (1). Cranial nerve palsies are seen rarely, and abducens nerve palsy has been reported in only three children. We describe a 2.5-year-old girl with incomplete KD who developed transient abducens nerve palsy after intravenous immunoglobulin (IVIG) treatment.

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VI nerve palsy after intravenous immunoglobulin in Kawasaki disease

Cited by 8 publications

References 13 publications

Adverse Effects of Immunoglobulin Therapy

Adverse Effects of Immunoglobulin Therapy

Involvement of Nervous System in Kawasaki Disease

Abducens nerve palsy in a girl with incomplete Kawasaki disease

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