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Updated: May 14, 2025

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Syncope and New-Onset Bifascicular Block Associated With Intravenous Immunoglobulin in a Patient With Chronic
Trevor Wolchover1, Harpreet Dosanjh1, Jonathan Lalezari1
1Internal Medicine, Los Robles Regional Medical Center, Thousand Oaks, USA.
Abstract:
Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated neuropathy often treated with intravenous immunoglobulin (IVIG), which is generally well-tolerated but has occasionally been associated with rare cardiovascular side effects. We present the case of an 84-year-old male with CIDP, maintained on biweekly IVIG infusions, who experienced a syncopal episode with documented bradycardia of 30 beats per minute (bpm) during an infusion. Upon evaluation in the emergency department, the patient was found to have a new bifascicular block requiring pacemaker placement. This case underscores a rare adverse reaction associated with IVIG infusion, highlighting the importance of careful cardiac monitoring in older patients with CIDP and underlying or potential cardiac risk factors.
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