Non-ST Elevation Myocardial Infraction after High Dose Intravenous Immunoglobulin Infusion

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Percutaneous Contrast Echocardiography-guided Intramyocardial Injection and Cell Delivery in a Large Preclinical Model
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Meir Mizrahi1, Tomer Adar, Efrat Orenbuch-Harroch

  • 1Internal Medicine A, Department of Medicine, Hebrew University-Hadassah Medical Center, Jerusalem IL 91120, Israel.

Case Reports in Medicine
|February 26, 2010
PubMed

Intravenous immunoglobulins (IVIgs) are used for several indications, including autoimmune conditions. IVIg treatment is associated with several possible adverse reactions including induction of a hypercoagulable state. We report a 76-year-old woman treated with IVIg for myasthenia gravis, which developed chest pain and weakness following IVIg infusion. The symptoms were associated with ST segment depression in V4-6 and elevated troponin levels. The patient was diagnosed with non-ST elevation myocardial infarction (NSTEMI). The patient had no significant risk factor besides age and a cardiac perfusion scan was interpreted as normal (the patient refused to undergo cardiac catheterization). This case is compatible with IVIg-induced hypercoagulability resulting in NSTEMI. Cardiac evaluation should therefore be considered prior to initiation of IVIg treatment especially in patients with multiple cardiovascular risks.

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