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Early platelet and leukocyte decline in patients with neuroinflammatory disorders after intravenous immunoglobulins
Author(s) -
Totzeck A.,
Stettner M.,
Hagenacker T.
Publication year - 2017
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13264
Subject(s) - medicine , tolerability , white blood cell , platelet , hemolysis , gastroenterology , polyradiculoneuropathy , antibody , hemoglobin , immunology , adverse effect , guillain barre syndrome
Background and purpose Intravenous immunoglobulins ( IVIG s) are a common therapy in patients with neuroinflammatory disorders, especially chronic inflammatory demyelinating polyradiculoneuropathy or Guillain−Barré syndrome. Hematological toxicities upon IVIG infusion are a known side effect and still an important subject of investigation. Methods Laboratory results and data for clinical efficacy and tolerability of 62 patients with neuroinflammatory disorders treated with IVIG (0.4 g/kg bodyweight per day over 5 days) at the Department of Neurology, University of Duisburg‐Essen, Germany, were retrospectively analyzed. Blood samples were taken before and 1 day after IVIG administration. Results In pre‐treated and first‐time treated patients, there was a significant decrease in white blood cell count ( WBC ) (8.10 ± 2.85/nl to 5.61 ± 2.50/nl, P < 0.001, n = 57) and platelets (255 ± 72/nl to 215 ± 66/nl, P < 0.001, n = 57). Mild hemolysis of red blood cells was found in patients who received IVIG for the first time (red blood cell count 4.61 ± 0.67/pl to 4.28 ± 0.52/pl, hemoglobin 13.7 ± 1.7 g/l to 13.0 ± 1.7 g/l, P < 0.001, n = 40). Hemolysis was associated with less tolerability of IVIG treatment and clinical efficacy was accompanied with a higher decline of WBC (not significant). Conclusions Next to mild hemolysis, a significant decrease in WBC and platelets can be detected early after high dose IVIG s in patients with neuroinflammatory disorders. Changes in blood counts may be possible markers for clinical efficacy and tolerability. Patients with low blood counts in advance should be particularly closely monitored whilst on IVIG treatment.