Can IVIG cause aseptic meningitis?

Can IVIG cause aseptic meningitis?

Abstract. Background: Aseptic meningitis is a rare and significant complication of intravenous immunoglobulin (IVIg) therapy. The true incidence is unknown as there are a number of case reports and few thorough reviews. Some have suggested the incidence being 0-1% with one reported exception of 11% in the literature.

Does IVIG affect CSF?

When subjects with various neurological disorders were given IVIg infusions, a significant increase in anti-Aβ antibodies in both CSF and serum was found. In CSF, the total amount of Aβ, and the amount of Aβ1–42 specifically, was shown to significantly decrease after IVIg infusions.

How long does IVIG aseptic meningitis take?

In the present study, aseptic meningitis developed within 25 to 40 hours after initiation of IVIG. In previous case reports, most patients also developed meningitis within 48 hours of beginning IVIG.

What is the CSF findings of aseptic meningitis?

Cerebrospinal fluid findings in patients with aseptic meningitis classically are described as elevated white blood cell counts with a predominance of lymphocytes, but polymorphonuclear (PMN) cells may predominate early in the course of the disease.

Why does IVIG cause meningitis?

The exact pathophysiology of IVIG-induced aseptic meningitis is not clear. The various postulated mechanisms include direct toxic effect, immunological drug hypersensitive reaction, allogenic immune reaction, hypersensitivity reaction to various stabilizing agents and cytokine release triggered by the therapy [4–6].

What does aseptic meningitis mean?

Aseptic meningitis is an umbrella term for all of the causes of inflammation of the brain meninges that have negative cerebrospinal fluid (CSF) bacterial cultures. It is one of the most common inflammatory disorders of the meninges.

How do you diagnose aseptic meningitis?

In most cases, your doctor will perform a spinal tap. During a spinal tap your doctor will extract cerebrospinal fluid from your spine. This is the only definitive way to diagnosis meningitis. Spinal fluid is made by the brain and surrounds the brain and spinal cord to protect it.

Can IVIG cause CSF leak?

Wada et al. [7] showed the excitotoxic effect of IVIG in acute encephalopathy following IVIG therapy. Other possible explanation can be the leaking of small quantities of IVIG into the CSF, thereby causing inflammatory reaction and osmotic shifts.

What is aseptic meningitis mean?

Aseptic meningitis is an illness characterized by serous inflammation of the linings of the brain (i.e., meninges), usually with an accompanying mononuclear pleocytosis. Clinical manifestations vary, with headache and fever predominating.

How long can you have aseptic meningitis?

Aseptic (viral) meningitis is serious but rarely fatal in healthy people with normal immune systems. Usually, symptoms last from 7 to 10 days and the patient recovers completely. People with this condition may have the following symptoms: Headache.

Does aseptic meningitis need to be treated?

Most people with aseptic meningitis recover in one to two weeks without medical treatment. You’ll be instructed to rest, drink plenty of water, and take medications to help relieve your symptoms. Analgesics and anti-inflammatory medications may be recommended for pain and fever control.

What does high IgG in CSF mean?

A CSF IgG index measures the levels of IgG in your cerebrospinal fluid. High levels of IgG can mean you have an autoimmune disorder. An autoimmune disorder causes your immune system to attack healthy cells, tissues, and/or organs by mistake. These disorders can cause serious health problems.

How do you interpret CSF IgG?

Cerebrospinal fluid (CSF) IgG synthesis rate indicates the rate of increase in the daily CSF production of IgG in milligrams per day. A result greater than 12 mg/24 hours is elevated. A CSF index greater than 0.85 is elevated and indicative of increased synthesis of IgG.

How long does IVIG last in the body?

The half-life of IVIG in the body is, on average, about 25 days. It usually takes roughly 4-5 half-lives to clear the majority of IVIG from your body. However, the usual frequency of IVIG dosing is more frequent to help maintain suitable IG levels and prevent them from dropping too low between dosing cycles.

What is the difference between bacterial and aseptic meningitis?

Bacterial meningitis was defined as the acute onset of meningitis and documented bacterial infection in the CSF (direct examination, culture, or latex agglutination) or blood culture. Aseptic meningitis was defined as the acute onset of meningitis and the absence of any bacterial meningitis criteria.