Transient derangements in Hepatitis B serology in patients post-intravenous immunoglobulin therapy—a case-based review

King, Catherine; Sutton-Fitzpatrick, Una; Houlihan, Julieanne

doi:10.1007/s11845-019-02115-3

Cited by 4 publications

(5 citation statements)

References 6 publications

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“…Before starting IVIG, a baseline acute hepatitis panel may be helpful in evaluating the significance of positive antibody titers, especially in patients without a confirmed prior infection or vaccination history. 10,13,14 Although the extent of liver enzyme elevation can be significant, as seen in our patient, it usually does not require aggressive treatment, and watchful waiting with supportive care is likely sufficient.…”

Section: Discussionmentioning

confidence: 69%

“…There are case reports that mention patients receiving IVIG who had positive hepatitis B antibodies, which was the result of passive transfer; liver enzyme elevation was observed in some of the patients. 3,[10][11][12][13][14] We initially suspected that our patient's elevated liver enzymes were due to drug-induced liver injury, and her positive anti-HBc antibodies were transferred to her bloodstream from the IVIG. Using the Roussel Uclaf Causality Assessment Model, her score of 5 indicated IVIG possibly caused a liver injury.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Elevated Liver Enzymes With Positive Hepatitis B Serology After Intravenous Immunoglobulin Treatment of Guillain-Barré Syndrome

Patel,

Le,

Puskoor

et al. 2023

ACG Case Rep J

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Intravenous immunoglobulin (IVIG) is used to treat multiple conditions, one of which is Guillain-Barré syndrome. Despite its multiple benefits, IVIG can cause a wide variety of side effects, most of which resolve with supportive care. We present a case in which a patient with new-onset Guillain-Barré syndrome was treated with IVIG and subsequently developed an acute elevation in liver enzymes with positive hepatitis B serology.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

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Elevated Liver Enzymes With Positive Hepatitis B Serology After Intravenous Immunoglobulin Treatment of Guillain-Barré Syndrome

Patel,

Le,

Puskoor

et al. 2023

ACG Case Rep J

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“…4,5 Studies have shown that in such cases of passive transfer hepatitis B antibodies the positive serologies may last for about 11 weeks after the last dose of IVIG. 6 In this case, a negative Hepatitis B DNA (viral load) and normal transaminases, although assuring, do not exclude chronic hepatitis. In this case, the results should be repeated three months 1.…”

Section: Hepatitis B Prior To Giving Intravenous Immunoglobulin (Ivig...mentioning

confidence: 80%

1-Minute Pearls/Pitfalls for the Clinician

Dapaah-Afriyie

2023

Journal of Brown Hospital Medicine

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“…Passive acquisition of various clinically important antibodies through therapies with IVIG has been reported before, particularly regarding hepatitis B surface and core IgG antibodies [10][11][12]15,[28][29][30], but rare case reports have also described false serology for hepatitis A, cytomegalovirus, syphilis, and toxoplasma [13][14][15]30]. A recent study by Hanson et al assessed the impact of IVIG therapy on a variety of common viral, bacterial, fungal, and parasitic serologies by prospectively evaluating serologic changes pre-and post-IVIG infusion in seven participants.…”

Section: Discussionmentioning

confidence: 99%

Misleading Positive Serology for Cat Scratch Disease following Administration of Intravenous Immunoglobulin

et al. 2022

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Cat scratch disease (CSD), caused by Bartonella henselae, usually presents as regional lymphadenopathy/lymphadenitis, known as typical CSD or as atypical CSD, which includes, among others, neurological manifestations. Serology for anti–B. henselae IgG antibodies is the most commonly used diagnostic tests for CSD. Intravenous immunoglobulin (IVIG) is given for an increasing number of medical conditions and may cause interference with serological testing. We report six patients with neurological manifestations and two patients with Kawasaki disease mimicking typical CSD, mistakenly diagnosed as CSD due to false-positive serology following IVIG therapy. Bartonella IgG serology was positive one to six days after IVIG administration and reverted to negative in seven of eight patients or significantly decreased (1 patient) ≤30 days later. In patients with CSD, IgG titers remained essentially unchanged 15–78 days after the positive serum sample. An additional eight patients treated with IVIG for various conditions were evaluated prospectively. All were seronegative one day pre-IVIG infusion, five patients demonstrated an increase in the IgG titers one to three days after IVIG administration, one interpreted as positive and four as intermediate, whereas three patients remained seronegative, suggesting that false seropositivity after IVIG therapy may not occur in all patients. Treatment with IVIG can result in false-positive serology for B. henselae. Increased awareness to the misleading impact of IVIG is warranted to avoid misinterpretation. Repeat testing can distinguish between true and false serology. Preserving serum samples prior to IVIG administration is suggested.

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Transient derangements in Hepatitis B serology in patients post-intravenous immunoglobulin therapy—a case-based review

Cited by 4 publications

References 6 publications

Elevated Liver Enzymes With Positive Hepatitis B Serology After Intravenous Immunoglobulin Treatment of Guillain-Barré Syndrome

Elevated Liver Enzymes With Positive Hepatitis B Serology After Intravenous Immunoglobulin Treatment of Guillain-Barré Syndrome

1-Minute Pearls/Pitfalls for the Clinician

Misleading Positive Serology for Cat Scratch Disease following Administration of Intravenous Immunoglobulin

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