Aseptic Meningitis and Intravenous Immunoglobulin Therapy
Authors: Curtis L. Scribner
Journal: Annals of Internal Medicine (1994)

Editorials15 August 1994Aseptic Meningitis and Intravenous Immunoglobulin TherapyCurtis L. Scribner, MD, Richard M. Kapit, MD, Evelyne T. Phillips, RPH, MA, and Nathaniel M. Rickles, BSCurtis L. Scribner, MDFood and Drug Administration, Rockville; MD 20852, Richard M. Kapit, MDFood and Drug Administration, Rockville; MD 20852, Evelyne T. Phillips, RPH, MAFood and Drug Administration, Rockville; MD 20852, and Nathaniel M. Rickles, BSFood and Drug Administration, Rockville; MD 20852Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-4-199408150-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Immunoglobulin fractionated from human plasma and specifically manufactured for intravenous use has been approved by the Food and Drug Administration (FDA) for many indications. From Nolte and colleagues' original 1979 report [1] showing the usefulness of this therapy in treating primary immunodeficiencies to Imbach and coworkers' study [2, 3] showing the efficacy of the therapy compared with that of corticosteroids in the treatment of idiopathic thrombocytopenic purpura, licensed indications have been expanded to include the treatment of Kawasaki disease and the prevention of bacterial infections in persons with chronic lymphocytic leukemia. Most recently, as noted by Sekul and colleagues in ...References1. Nolte MT, Pirosfsky B, Gerritz GA, Golding B. Intravenous immunoglobulin therapy for antibody deficiency. Clin Exp Immunol. 1979; 36:237-43. Google Scholar2. Imbach P, Barandun S, d'Apuzzo V, Baumgarten C, Hirt A, Morell A, et al. High-dose intravenous gammaglobulin for idiopathic thrombocytopenic purpura in childhood. Lancet. 1981; 1:1228-31. Google Scholar3. Imbach P, Wagner HP, Berchtold W, Gaedicke G, Hirt A, Joller P, et al. Intravenous immunoglobulin versus oral corticosteroids in acute immune thrombocytopenic purpura in childhood. Lancet. 1985; 2:464-8. Google Scholar4. Sekul E, Cupler E, Dalakas M. Aseptic meningitis associated with high-dose intravenous immunoglobulin therapy: Frequency and risk factors. Ann Intern Med. 1994; 121:259-62. Google Scholar5. Kato E, Shindo S, Eto Y, Hashimoto N, Yamamoto M, Sakata Y, et al. Administration of immune globulin associated with aseptic meningitis (Letter). JAMA. 1988; 259:3269-70. Google Scholar6. Casteels-Van Daele M, Wijndaele L, Hanninck K, Gillis P. Intravenous immunoglobulin and acute aseptic meningitis (Letter). N Engl J Med. 1990; 323:614-5. Google Scholar7. Watson JD, Gibson J, Joshua DE, Kronenberg H. Aseptic meningitis associated with high dose intravenous immunoglobulin therapy. J Neurol Neurosurg Psychiatry. 1991; 54:275-6. Google Scholar8. Molina JM, Coffineau A, Rain JD, Letonurier D, Modai J. Aseptic meningitis following administration of intravenous immune globulin (Letter). Clin Infect Dis. 1992; 15:564-5. Google Scholar9. Vera-Ramirez M, Charlet M, Parry GJ. Recurrent aseptic meningitis complicating intravenous immunoglobulin therapy for chronic inflammatory demyelinating polyradiculoneuropathy. Neurology. 1992; 42:1636-7. Google Scholar10. Mitterrer M, Pescosta N, Vogetseder W, Mair M, Coser P. Two episodes of aseptic meningitis during intravenous immunoglobulin therapy of idiopathic thrombocytopenic purpura (Letter). Ann Hematol. 1993; 67:151-2. Google Scholar11. Meiner Z, Ben-Hur T, River Y, Reches A. Aseptic meningitis as complication of intravenous immunoglobulin therapy for myasthenia gravis (Letter). J Neurol Neurosurg Psychiatry. 1993; 56:830-1. Google Scholar12. Casteels-Van Daele M, Wijndaele L, Brock P, Kruger M, Gillis P. Aseptic meningitis associated with high dose intravenous immunoglobulin therapy (Letter). J Neurol Neurosurg Psychiatry. 1992; 55:980-1. Google Scholar13. Bussel J, Cunningham-Rundles C, Feldman C, Horowitz B. Transmission of viral infection by preparations of intravenous immunoglobulin. Plasma Ther Transfus Technol. 1988; 9:193-205. Google Scholar14. Kessler DA. Introducing MEDWatch. A new approach to reporting medication and device adverse effects and product problems. JAMA. 1993; 269:2765-8. Google Scholar15. Van der Meche F, Kleyweg R. Aseptic meningitis associated with high dose intravenous immunoglobulin therapy. J Neurol Neurosurg Psychiatry. 1993; 56:981. Google Scholar Author, Article, and Disclosure InformationAuthors: Curtis L. Scribner, MD; Richard M. Kapit, MD; Evelyne T. Phillips, RPH, MA; Nathaniel M. Rickles, BSAffiliations: Food and Drug Administration, Rockville; MD 20852Corresponding Author: Curtis L. Scribner, MD, Office of Blood Research and Review, Food and Drug Administration, HFM-370, 1401 Rockville Pike, Rockville, MD 20852-1448. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAseptic Meningitis Associated with High-Dose Intravenous Immunoglobulin Therapy: Frequency and Risk Factors Elizabeth A. Sekul , Edward J. Cupler , and Marinos C. Dalakas Metrics Cited byIntravenous Immunoglobulin-Induced Aseptic Meningitis—A Narrative Review of the Diagnostic Process, Pathogenesis, Preventative Measures and TreatmentNeutropenia resulting from high‐dose intravenous immunoglobulin in dermatological patientsNeutropenie als Nebenwirkung der Therapie mit hochdosierten intravenösen Immunglobulinen in der DermatologieDiagnosis and management of Kawasaki diseaseImmunoglobulin Treatment in Neuromuscular MedicineA Nasty, Rare and Ironic Unwanted EffectHistorical Aspects of Polyclonal IgG PreparationsCritical review of the role of intravenous immunoglobulins in idiopathic inflammatory myopathiesAseptic meningitis following therapy with immune globulins: a combination of product features and patient characteristics?Selecting a polyclonal immune globulin treatment for a patient with primary immune deficiency disease: Role of the clinical pharmacistImmunoglobulin TherapyManagement of adverse events in the treatment of patients with immunoglobulin therapy: A review of evidenceImmunoglobulin Replacement Therapy for Primary ImmunodeficiencyIncidence and natural history of intravenous immunoglobulin-induced aseptic meningitis: a retrospective review at a single tertiary care centerImmunoglobulin Replacement Therapy: Past, Present, FutureAdverse Effects of Human Immunoglobulin TherapyHuman Intravenous Immunoglobulin-Induced Aseptic Meningitis: A Case ReportPassive ImmunizationCentral Nervous System Infections in Cancer PatientsIntravenous Immune Serum Globulin (IVIG) Therapy in Patients with Antibody Immune DeficiencyHeadache attributed to non-vascular intracranial disorderEfficacy and safety of Privigen ® , a novel liquid intravenous immunoglobulin formulation, in adolescent and adult patients with chronic immune thrombocytopenic purpuraPeripheral NeuropathyPassive ImmunizationClinical Trial of Safety and Efficacy of IHN-A21 for the Prevention of Nosocomial Staphylococcal Bloodstream Infection in Premature InfantsIntravenous immunoglobulins contain naturally occurring antibodies that mimic antineutrophil cytoplasmic antibodies and activate neutrophils in a TNFα-dependent and Fc-receptor–independent wayPharmacovigilance study of a regional intravenous immunoglobulin (II): evaluation and comparison of an improved pharmaceutical formTreatment of Immune Thrombocytopenic Purpura in ChildrenEstudio de farmacovigilancia de una inmunoglobulina endovenosa regionalIntravenous immune globulins: an update for cliniciansCentral Nervous System Infections in AdultsRandomized Trial of High-Dose Methylprednisolone Versus Intravenous Immunoglobulin for the Treatment of Acute Idiopathic Thrombocytopenic Purpura in ChildrenCerebral infarction following intravenous immunoglobulin therapy for Guillain-Barre syndromeREPLACEMENT INTRAVENOUS IMMUNE SERUM GLOBULIN THERAPY IN PATIENTS WITH ANTIBODY IMMUNE DEFICIENCYAseptic Meningitis Due to Intravenous Immunoglobulin Therapy That Resolved with Subcutaneous AdministrationBorrowed Antibodies: The Characteristics and Roles of Immune GlobulinsAcute Aseptic Meningitis Associated with Administration of Immunoglobulin in Children: A Case Report and Review of the LiteratureA Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial of High-Dose Intravenous Immunoglobulin for Oral Corticosteroid-Dependent AsthmaACUTE ASEPTIC MENINGITIS SECONDARY TO INTRAVENOUS IMMUNOGLOBULIN IN A PATIENT WITH KAWASAKI SYNDROMEACUTE PERIPHERAL NEUROPATHY IN ADULTSHuman intravenous immunoglobulin in primary and secondary antibody deficienciesNeurologic complications of treatment of childhood acute immune thrombocytopenic purpura with intravenously administered immunoglobulin GMeningitis and Hepatitis Complicating Intravenous Immunoglobulin TherapyMéningite aseptique au cours d'un traitement par immunoglobulinesComplications of intravenous gammaglobulin in neuromuscular and other diseasesADJUNCTS TO ANTIBACTERIAL THERAPY 15 August 1994Volume 121, Issue 4Page: 305-306KeywordsCerebrospinal fluidCorticosteroid therapyFeversFood and Drug AdministrationHeadachesIdiopathic thrombocytopenic purpuraImmunodeficienciesIntravenous immunoglobulinMeningitisVomiting ePublished: 15 August 2000 Issue Published: 15 August 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. 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