Stroke intravenous immunoglobulin

Intravenous immunoglobulin expands the plasma volume and increases blood viscosity, which can lead to volume overload in patients with cardiac insufficiency (41). Stroke, thromboembolic events, and myocardial infarction have been reported after high-dose treatment with intravenous immunoglobulin, which increases plasma viscosity (41 3). 

Thrombosis in elderly patients with an increased risk of thrombosis, such as those with hypertension or previous episodes of infarction, has been described (44). A few cases of thrombosis subsequent to intravenous immunoglobulin have been reported, including myocardial infarction in five patients, stroke in four cases, and spinal cord ischemia in one (45). It has been postulated that these events are induced by platelet activation and increased plasma viscosity (12). 

A 54-year-old woman with idiopathic thrombocytopenic purpura received intravenous immunoglobulin 1 g/kg/day for 2 days and had an ischemic stroke with hemiparesis 3 days later she had a deep vein thrombosis (47). 

Stroke and ischemic encephalopathy, probably caused by cerebral vasospasm after intravenous immunoglobulin, have been reported as possible comphcations of intravenous immunoglobuhn (63). 

Several cases of intravenous immunoglobulin-related thrombosis have been reported (78,79). It can be either venous or arterial (80). It has been suggested that thrombosis can be caused by platelet activation and increased plasma viscosity (79). In patients with vascular risk factors, such as old age, hypertension, and a history of stroke or coronary artery disease, complications, such as myocardial infarction, pulmonary embolism, stroke, and acute spinal cord events, have been described (80). Intravenous immunoglobulin enhances platelet aggregation and the release of adenosine triphosphate in human platelets in vitro. In addition, there is a dose-related increase in plasma viscosity with increasing plasma immunoglobulin concentration (79,80). 

Cardiovascular Blood pressure changes, tachycardia, phlebitis, stroke, myocardial infarction, and collapse have been associated with intravenous immunoglobulin in patients at risk [39 , 40, 43, 45, 52 , 53 . One patient with impairment of preexisting hypertension benefited from increasing the administration period from 2 to 3 days [54. ... 

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