J Korean Med Sci.  2007 Aug;22(4):758-761. 10.3346/jkms.2007.22.4.758.

A Case of Deep Vein Thrombosis and Pulmonary Thromboembolism after Intravenous Immunoglobulin Therapy

• Lee YJ
• Shin JU
• Lee J
• Kim K
• Kim WS
• Ahn JS
• Jung CW
• Kang WK

• KMID: 1127102
• DOI: http://doi.org/10.3346/jkms.2007.22.4.758

Abstract

Although high-dose intravenous immunoglobulin (IVIG) is generally considered a safe medication for various immune-mediated diseases, thrombotic events have been reported as a complication of the therapy. We report a case who developed thrombotic complications after receiving IVIG. A 56-yr-old woman with idiopathic thrombocytopenic purpura received IVIG at a dose of 400 mg/kg/day for five days. Three days after the administration of IVIG, the patient developed painful edema in the left leg. Lower extremity doppler ultrasound revealed deep vein thrombosis in the left leg. Chest computed tomography (CT) scan demonstrated a filling defect indicating thromboembolism of the right pulmonary artery. After three weeks of enoxaparin therapy, her symptoms and pulmonary embolism on CT improved. This case suggests clinicians should be cautious in the development of thromboembolism by administration of IVIG, especially in patients with thrombophilia.

Keyword

Intravenous Immunoglobulins; Idiopathic Thrombocytopenic Purpura; Deep Vein Thrombosis; Pulmonary Embolism

MeSH Terms

Female
Humans
Immunoglobulins, Intravenous/*adverse effects/therapeutic use
Middle Aged
Pulmonary Embolism/*chemically induced
Purpura, Thrombocytopenic, Idiopathic/drug therapy
Venous Thrombosis/*chemically induced

Figure

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  Fig. 1 Lower extremity Doppler ultrasound revealed thrombus in the left femoral vein.

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  Fig. 2 Chest computed tomography scan revealed a filling defect in the right interlobar pulmonary artery (arrow), indicating pulmonary thromboembolism.

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  Fig. 3 The filling defect in the right interlobar pulmonary artery disappeared after 3 weeks of enoxaparin therapy.

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