When the Treatment Becomes the Problem: A Case of Paradoxical Case Effects of IVIG
Intravenous immunoglobulin (IVIG) is commonly used for immunomodulation in autoimmune diseases but can induce rare complications, such as hemolytic anemia. We report a case of a 19-year-old woman with Crohn disease complicated by pyoderma gangrenosum, presenting with IVIG-induced hemolytic anemia an...
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| Format: | Article |
| Language: | English |
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American College of Physicians
2025-04-01
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| Series: | Annals of Internal Medicine: Clinical Cases |
| Online Access: | https://www.acpjournals.org/doi/10.7326/aimcc.2024.1195 |
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| author | Rupayan Kundu Mikinzi Casto Alyson M. Rich Genesys Santana Richard M. Wardrop |
| author_facet | Rupayan Kundu Mikinzi Casto Alyson M. Rich Genesys Santana Richard M. Wardrop |
| author_sort | Rupayan Kundu |
| collection | DOAJ |
| description | Intravenous immunoglobulin (IVIG) is commonly used for immunomodulation in autoimmune diseases but can induce rare complications, such as hemolytic anemia. We report a case of a 19-year-old woman with Crohn disease complicated by pyoderma gangrenosum, presenting with IVIG-induced hemolytic anemia and a distinctive rash. Following two doses of IVIG, she experienced headaches, rash, and tachycardia. Laboratory findings showed anemia, hyperbilirubinemia, and a positive Coombs test. She was managed with supportive care. This case underscores the need for vigilant monitoring for hemolysis in patients receiving IVIG, especially those with cumulative doses and underlying inflammatory conditions. |
| format | Article |
| id | doaj-art-8a15e872b3ee42c2aeb6ae989fe972ff |
| institution | OA Journals |
| issn | 2767-7664 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | American College of Physicians |
| record_format | Article |
| series | Annals of Internal Medicine: Clinical Cases |
| spelling | doaj-art-8a15e872b3ee42c2aeb6ae989fe972ff2025-08-20T02:16:13ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642025-04-014410.7326/aimcc.2024.1195When the Treatment Becomes the Problem: A Case of Paradoxical Case Effects of IVIGRupayan Kundu0Mikinzi Casto1Alyson M. Rich2Genesys Santana3Richard M. Wardrop41Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio2Department of Exercise Physiology, School of Medicine, West Virginia University, Morgantown, West Virginia3Department of Neurology, Cleveland Clinic Foundation, Cleveland, Ohio4Case Western Reserve University School of Medicine, Cleveland, Ohio5Department of Hospital Medicine, University Hospitals, Cleveland, OhioIntravenous immunoglobulin (IVIG) is commonly used for immunomodulation in autoimmune diseases but can induce rare complications, such as hemolytic anemia. We report a case of a 19-year-old woman with Crohn disease complicated by pyoderma gangrenosum, presenting with IVIG-induced hemolytic anemia and a distinctive rash. Following two doses of IVIG, she experienced headaches, rash, and tachycardia. Laboratory findings showed anemia, hyperbilirubinemia, and a positive Coombs test. She was managed with supportive care. This case underscores the need for vigilant monitoring for hemolysis in patients receiving IVIG, especially those with cumulative doses and underlying inflammatory conditions.https://www.acpjournals.org/doi/10.7326/aimcc.2024.1195 |
| spellingShingle | Rupayan Kundu Mikinzi Casto Alyson M. Rich Genesys Santana Richard M. Wardrop When the Treatment Becomes the Problem: A Case of Paradoxical Case Effects of IVIG Annals of Internal Medicine: Clinical Cases |
| title | When the Treatment Becomes the Problem: A Case of Paradoxical Case Effects of IVIG |
| title_full | When the Treatment Becomes the Problem: A Case of Paradoxical Case Effects of IVIG |
| title_fullStr | When the Treatment Becomes the Problem: A Case of Paradoxical Case Effects of IVIG |
| title_full_unstemmed | When the Treatment Becomes the Problem: A Case of Paradoxical Case Effects of IVIG |
| title_short | When the Treatment Becomes the Problem: A Case of Paradoxical Case Effects of IVIG |
| title_sort | when the treatment becomes the problem a case of paradoxical case effects of ivig |
| url | https://www.acpjournals.org/doi/10.7326/aimcc.2024.1195 |
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