Embolic Ischemic Stroke Associated with Maintenance Intravenous Immunoglobulin Therapy.
Ryoji Miyano, Yu Yoshida, Kazuki Fujita et al.
✦ AI-curated · Sources linked
Case in brief
A 51-year-old man receiving long-term maintenance intravenous immunoglobulin (IVIG) for chronic inflammatory demyelinating polyradiculoneuropathy developed acute right-hand clumsiness immediately after his 112th infusion. Brain MRI showed an acute embolic infarction. No ischemic stroke risk factors or alternative embolic sources were identified. He had previously tolerated IVIG, and the report describes the stroke occurring during otherwise uneventful maintenance therapy.
What made this case unusual
The embolic stroke occurred in a relatively young patient without identified stroke risk factors or another embolic source, despite prolonged, previously well-tolerated maintenance IVIG.
Diagnostic / clinical pearl
Acute focal neurologic symptoms during maintenance IVIG warrant prompt evaluation for ischemic stroke, even when prior infusions were uneventful and conventional risk factors are absent.