Occurrence of hemolytic anemia in patients with GBS treated with high-dose IVIg.

Abstract

OBJECTIVE:

We describe an underrecognized side effect of high-dose IV immunoglobulin (IVIg), hemolytic anemia.

BACKGROUND:

There are no established guidelines on treating patients with Guillain-Barré syndrome (GBS) who relapse or do not improve after a standard course of treatment (IVIg or plasma exchange). Some centers will opt for a second course of the initial treatment. There is an ongoing trial of a second course of IVIg in patients with severe GBS.

METHODS:

We retrospectively reviewed 4 patients with severe GBS who received high-dose IVIg. One patient inadvertently received a high dose of IVIg for Miller Fisher syndrome. All patients received a total of at least 2 courses of the standard dose of IVIg (total >4 g/kg). We review their clinical course and side effects.

RESULTS:

All patients with non-O blood types developed clinically significant hemolytic anemia requiring blood transfusion.

CONCLUSION:

Hemolytic anemia may limit doses of IVIg for treatment of severe GBS in patients with non-O blood types.

• Authors: Thy P Nguyen, Suur Biliciler, Amer Wahed, Kazim Sheikh
• Journal: Neurology(R) neuroimmunology & neuroinflammation (Neurol Neuroimmunol Neuroinflamm) Vol. 1 Issue 4 Pg. e50 (Dec 2014) ISSN: 2332-7812 [Print] United States
• PMID: 25520957 (Publication Type: Journal Article)