IVIG Associated Aseptic Meningitis in a Renal Transplant Patient

Wanigasekera, Tamara; Grainger, Rachel J.; Sexton, Donal J.; Magee, Colm

doi:10.1155/2017/6962150

Cited by 3 publications

(4 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The mechanism by which IVIg therapy can cause AM is not completely understood, and it is supposed to be more complex than direct meningeal irritation. Suggested mechanisms include cerebral vasospasm, neutrophil activation, and hypersensitivity reaction [ 47 ].…”

Section: Resultsmentioning

confidence: 99%

Aseptic Meningitis in Oral Medicine: Exploring the Key Elements for a Challenging Diagnosis: A Review of the Literature and Two Case Reports

Leuci¹,

Coppola²,

Cantile³

et al. 2022

IJERPH

View full text Add to dashboard Cite

Aseptic meningitis (AM) is a potentially severe and life-threatening disease characterized by meningeal inflammation, usually with mononuclear pleocytosis. It represents a challenging and controversial issue in medicine for multiple etiologies, classification, and difficult diagnosis in the face of nonspecific sets of signs and symptoms. In the area of interest of oral medicine, in specific clusters of patients, even if rare, the occurrence of aseptic meningitis can pose a diagnostic and management dilemma in the following potential etiologies: (i) systemic diseases with oral and meningeal involvement, which include Behçet’s disease and Sjögren syndrome; (ii) drug-induced aseptic meningitis; (iii) aseptic viral meningitis, mostly related to herpes simplex virus infection and hand, foot, and mouth disease, caused by enteroviruses. In this review, clinical manifestations, diagnostic methodologies, incidence, treatment, and prognosis for each of these clinical entities are provided. Furthermore, two illustrative case reports are described: a patient suffering from recurrent oral ulcers, in which a sudden onset of AM allows us to diagnose Neuro Behçet’s disease, and a patient affected by pemphigus vulgaris, manifesting a drug-induced AM. Exploring this complex clinical entity scenario, it is clear that an oral medicine specialist has a place on any multidisciplinary team in making such a challenging diagnosis.

show abstract

Section: Resultsmentioning

confidence: 99%

Aseptic Meningitis in Oral Medicine: Exploring the Key Elements for a Challenging Diagnosis: A Review of the Literature and Two Case Reports

Leuci¹,

Coppola²,

Cantile³

et al. 2022

IJERPH

View full text Add to dashboard Cite

show abstract

“…Aseptic meningitis, a diagnosis of exclusion, refers to a process free from bacterial, viral, or fungal contamination [55]. Aseptic meningitis can prove a diagnostic obstacle as both clinical and cerebrospinal fluid (CSF) findings can make it indistinguishable from infectious meningitis [52,56]. Computed tomography (CT) of the brain is generally free of acute changes [50].…”

Section: Diagnosis Of Aseptic Meningitis In Clinical Practicementioning

confidence: 99%

“…The analysis of the cerebrospinal fluid is a crucial step in determining the correct diagnosis. Viral (cytomegalovirus, enterovirus, Herpes simplex virus, Varicella zoster virus) and bacterial etiology (Neisseria meningitidis, Streptococcus pneumoniae, Cryptococcus neoformans, Listeria monocytogenes) of meningitis should be excluded [52]. Numerous examinations of CSF of patients with suspected drug-induced aseptic meningitis revealed pleocytosis of hundred to several thousand cells with neutrophil dominance [53,55], leukocytes level in the CSF reaching as high as 7440 × 10 6 g/dL [33].…”

Section: Diagnosis Of Aseptic Meningitis In Clinical Practicementioning

confidence: 99%

“…The symptoms usually alleviate shortly after immediate cessation of the causative agent and 2-3 days of symptomatic treatment [70]. On occasion empiric antimicrobial therapy preferably with ceftriaxone is instantly initiated as a precautionary measure and is discontinued after negative blood cultures [41,52]. Treatment of aseptic meningitis relies mainly on symptom alleviation i.e., antiemetics in case of nausea and analgesics for the headache [18].…”

Section: Treatment Of Ivig-induced Aseptic Meningitismentioning

confidence: 99%

See 1 more Smart Citation

Intravenous Immunoglobulin-Induced Aseptic Meningitis—A Narrative Review of the Diagnostic Process, Pathogenesis, Preventative Measures and Treatment

Krętowska-Grunwald

Krawczuk-Rybak

Sawicka-Żukowska

2022

JCM

View full text Add to dashboard Cite

Intravenous immunoglobulins (IVIGs) are widely used in the treatment of numerous diseases in both adult and pediatric populations. Higher doses of IVIGs usually serve as an immunomodulatory factor, common in therapy of children with immune thrombocytopenic purpura. Considering the broad range of IgG applications, the incidence of side effects in the course of treatment is inevitable. Aseptic meningitis, an uncommon but significant adverse reaction of IVIG therapy, can prove a diagnostic obstacle. As of April 2022, forty-four cases of intravenous immunoglobulin-induced aseptic meningitis have been reported in the English-language literature. This review aims to provide a thorough overview of the diagnostic process, pathophysiology, possible preventative measures and adequate treatment of IVIG-induced aseptic meningitis.

show abstract

Acute Aseptic Meningitis Temporally Associated with Intravenous Polyclonal Immunoglobulin Therapy: A Systematic Review

De Felice,

Toti,

Gatti

et al. 2024

Clinic Rev Allerg Immunol

View full text Add to dashboard Cite

An acute aseptic meningitis has been occasionally observed on intravenous polyclonal human immunoglobulin therapy. Since case reports cannot be employed to draw inferences about the relationships between immunoglobulin therapy and meningitis, we conducted a systematic review and meta-analysis of the literature. Eligible were cases, case series, and pharmacovigilance studies. We found 71 individually documented cases (36 individuals ≤ 18 years of age) of meningitis. Ninety percent of cases presented ≤ 3 days after initiating immunoglobulin therapy and recovered within ≤ 7 days (with a shorter disease duration in children: ≤ 3 days in 29 (94%) cases). In 22 (31%) instances, the authors noted a link between the onset of meningitis and a rapid intravenous infusion of immunoglobulins. Cerebrospinal fluid analysis revealed a predominantly neutrophilic (N = 46, 66%) pleocytosis. Recurrences after re-exposure were observed in eight (N = 11%) patients. Eight case series addressed the prevalence of meningitis in 4089 patients treated with immunoglobulins. A pooled prevalence of 0.6% was noted. Finally, pharmacovigilance data revealed that meningitis temporally associated with intravenous immunoglobulin therapy occurred with at least five different products. In conclusion, intravenous immunoglobulin may cause an acute aseptic meningitis. The clinical features remit rapidly after discontinuing the medication.

show abstract

IVIG Associated Aseptic Meningitis in a Renal Transplant Patient

Cited by 3 publications

References 11 publications

Aseptic Meningitis in Oral Medicine: Exploring the Key Elements for a Challenging Diagnosis: A Review of the Literature and Two Case Reports

Aseptic Meningitis in Oral Medicine: Exploring the Key Elements for a Challenging Diagnosis: A Review of the Literature and Two Case Reports

Intravenous Immunoglobulin-Induced Aseptic Meningitis—A Narrative Review of the Diagnostic Process, Pathogenesis, Preventative Measures and Treatment

Acute Aseptic Meningitis Temporally Associated with Intravenous Polyclonal Immunoglobulin Therapy: A Systematic Review

Contact Info

Product

Resources

About