Embolic Ischemic Stroke Associated with Maintenance Intravenous Immunoglobulin Therapy

Area of Science:

• Neurology
• Immunology
• Vascular Medicine

Background:

• Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a rare autoimmune disorder affecting peripheral nerves.
• Intravenous immunoglobulin (IVIG) is a common treatment for CIDP, generally considered safe.
• Long-term IVIG maintenance therapy is often required for managing CIDP symptoms.

Purpose of the Study:

• To report a rare case of embolic ischemic stroke occurring during long-term IVIG therapy for CIDP.
• To emphasize the potential for serious adverse events even with well-tolerated treatments.
• To highlight the need for continued vigilance in patients receiving maintenance IVIG.

Main Methods:

• Case report of a 51-year-old male patient with CIDP.
• Detailed review of the patient's medical history and IVIG treatment course.
• Neuroimaging (Brain MRI) to confirm embolic infarction.
• Assessment for traditional stroke risk factors and alternative embolic sources.

Main Results:

• The patient experienced an acute embolic ischemic stroke immediately after his 112th IVIG infusion.
• No identifiable traditional risk factors for stroke or other embolic sources were found.
• The stroke occurred despite the patient having tolerated IVIG well for years.

Conclusions:

• Embolic stroke is a potential, albeit rare, complication of long-term IVIG therapy for CIDP.
• This risk exists even in younger, otherwise low-risk individuals.
• Healthcare providers should maintain vigilance for neurological events in patients on maintenance IVIG.