Reply: Meningitis and Skin Reaction after Intravenous Immune Globulin Therapy
Authors: Marinos C. Dalakas
Journal: Annals of Internal Medicine (1997)

Letters15 December 1997Reply: Meningitis and Skin Reaction after Intravenous Immune Globulin TherapyMarinos C. Dalakas, MDMarinos C. Dalakas, MDNational Institutes of Health; Bethesda, MD 20892-1382Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-12-199712150-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Gabor reports that IVIg-associated aseptic meningitis mandates a lumbar puncture and has a protracted course, requiring 9 to 14 days of hospitalization. I have a different view. We have reported [1, 2] that IVIg-associated aseptic meningitis is aseptic, not bacterial. Cultures of the cerebrospinal fluid in all six of our originally studied cases were negative [1]. In addition, no cases of bacterial meningitis have been reported; hence, I do not advocate the use of antibiotic prophylaxis.For the treatment of chronic autoimmune neurologic diseases, repeated IVIg infusions are needed. In some patients, especially those with migraine [1], ...References1. Sekul EA, Cupler EJ, Dalakas MC. Aseptic meningitis associated with high-dose intravenous immunoglobulin therapy: frequency and risk factors. Ann Intern Med. 1994; 121:259-62. Google Scholar2. Dalakas MC. Aseptic meningitis and intravenous immunoglobulin therapy [Letter]. Ann Intern Med. 1995; 122:316-7. Google Scholar3. Dalakas MC, Quarles RH, Farrer RZ, Dambrosia J, Soueidan S, Stein D, et al. A controlled study of intravenous immunoglobulin in demyelinating neuropathy with IgM gammopathy. Ann Neurol. 1995; 38:302-3. Google Scholar Author, Article, and Disclosure InformationAffiliations: National Institutes of Health; Bethesda, MD 20892-1382 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byIncidence and natural history of intravenous immunoglobulin-induced aseptic meningitis: a retrospective review at a single tertiary care centerImmunotherapy in the Treatment of Autoimmune Neuromuscular DiseasesPompholyx and eczematous reactions associated with intravenous immunoglobulin therapyAdverse effects of treatment with intravenous immunoglobulins for neurological diseasesAutoimmune neuropathies and treatment with intravenous immunoglobulinsThe use of intravenous immunoglobulin in the treatment of autoimmune neuromuscular diseases: evidence-based indications and safety profileTreatment of Myasthenia GravisIntravenous immunoglobulin treatment in peripheral nerve disorders - indications, mechanisms of action and side-effectsIntravenous immunoglobulin in the treatment of autoimmune neuromuscular diseases: Present status and practical therapeutic guidelines 15 December 1997Volume 127, Issue 12Page: 1130KeywordsAutoimmune diseasesBacterial meningitisHospitalizationsImmune responseLumbar punctureMeningitisMyelomaPruritusSkin reactionSubarachnoid hemorrhage Issue Published: 15 December 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...