Open AccessIntravenous immunoglobulin-associated renal failure in a patient with post-transfusion purpura
Author(s) -
Sujith V. Cherian,
Subhraleena Das,
Amarinder Singh Garcha,
Divey Manocha,
Nitish Kosaraju
Publication year - 2012
Publication title -
annals of saudi medicine/annals of saudi medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.373
H-Index - 44
eISSN - 0975-4466
pISSN - 0256-4947
DOI - 10.5144/0256-4947.2012.01.7.1500
Subject(s) - medicine , nephropathy , adverse effect , etiology , renal function , thrombocytopenic purpura , renal biopsy , antibody , purpura (gastropod) , diabetes mellitus , immunology , platelet , ecology , biology , endocrinology
Intravenous immunoglobulin (IVIG), initially developed for immunodeficiency disorders, has now been used for multiple autoimmune diseases and infections. These are generally well tolerated, with few adverse effects. Acute kidney injury has been described in very rare instances. We report an interesting case of a 59-year-old African American male with a pertinent history of diabetes mellitus, hypertension, endocarditis, and peripheral vascular disease, who was diagnosed with post-transfusion purpura. He was then treated with IVIG and subsequently developed an acute worsening of renal function in a time span of 3 days. The etiology remained elusive even after an extensive workup. Renal biopsy was done finally, which showed findings suggestive of osmotic nephropathy that was traced to the sucrose used as a stabilizing agent in the IVIG. In light of the increasing use of IVIG, it is therefore highly recommended that clinicians are well aware of this side effect of IVIG.