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Published on: August 9, 2013
Acute renal failure associated with immunoglobulin therapy
T G Cantú1, E W Hoehn-Saric, K M Burgess
1Division of Clinical Pharmacology, Johns Hopkins University School of Medicine, Baltimore, MD 21205-2196.
Summary
Intravenous immunoglobulin (IVIG) can cause acute kidney injury. This condition, characterized by tubular vacuolization, typically resolves rapidly after discontinuing IVIG treatment.
Area of Science:
- Nephrology
- Immunology
- Pharmacology
Background:
- Intravenous immunoglobulin (IVIG) is a therapy used for various autoimmune and immune deficiency disorders.
- Acute renal failure is a potential, though uncommon, adverse effect associated with IVIG administration.
Observation:
- This study presents four cases of acute renal failure following IVIG therapy.
- Clinical presentations ranged from mild creatinine elevation to anuric renal failure.
Findings:
- Renal histology revealed significant tubular vacuolization and cellular swelling, with brush border preservation.
- Glomerular cells also showed swelling and vacuolization, without evidence of inflammation or immune complex deposition.
- The observed renal effects appear to be a reversible consequence of immunoglobulins or carbohydrate additives in IVIG preparations on cellular function.
Implications:
- Clinicians should be aware of the risk of IVIG-induced nephrotoxicity.
- Prompt cessation of IVIG therapy can lead to rapid recovery of renal function.
- Further research into the specific components of IVIG responsible for renal effects is warranted.
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