Central Retinal Vein Occlusion Following Intravenous Immunoglobulin Treatment in a Patient with Pemphigus Vulgaris

Yıl 2017, , 53 - 56, 21.04.2017

Aysun Şanal Doğan

https://doi.org/10.1501/Tipfak_0000000963

Öz

A 68-year-old male has been treated with prednisolone and intravenous immunoglobulin (IVIG) therapies with the diagnosis of pemphigus vulgaris. When he applied to receive the fifth session of IVIG therapy, he complained about visual loss. On the ophthalmologic examination, left central retinal vein occlusion (CRVO) was determined. There was no other detected underlying cause for CRVO and it was thought that central retinal vein thrombosis might be due to IVIG therapy.

IVIG treatment is generally accepted reliable for pemphigus vulgaris. However, it can rarely cause serious side effects like thrombosis. In literature, there are a few cases of central retinal vein occlusion due to IVIG therapy and none of these have dermatological disease as their etiology. 

Anahtar Kelimeler

Central Retinal Vein Occlusion, Intraven ous Immunoglobulin

Kaynakça

• 1. Schiavo AL, Puca RV, Ruocco V, Ruocco E: Adjuvant drugs in autoimmune bullous diseases, efficacy versus safety: Facts and controversies. Clinics in Dermatology. 2010; 28:337-343.
• 2. Oh KT, Boldt HC, Danis RP: Iatrogenic central retinal vein occlusion and hyperviscosity associated with high-dose intravenous immunoglobulin administration. Am J Ophthalmol. 1997 ;124:416-418.
• 3. Harkness KA, Goulding P:Central retinal vein occlusion complicating treatment with intravenous immunoglobulin. Eye(Lond). 2000; 14:662-663.
• 4. Palacio GL, Gabbai AA, Muccioli C, et al. Images in Medicine. Occlusion of the central vein of the retina after treatment with intravenous human immunoglobulin. Rev Assoc Med Bras. 2004; 50:246.
• 5. Nawasiwatte BMTP, Somaratne SC, Fernando A, et al. Retinal vein occlusion following intravenous immunoglobulin treatment. Ceylon Medical Journal. 2012; 57:170-171.
• 6. Gelman R, Dimango EA, Schiff WM: Sequential bilateral central retinal vein occlusions in a cystic fibrosis patient with hyperhomocysteinemia and hypergammaglobulinemia. Retin Cases Brief Rep. 2013; 7:362-367.
• 7. Lee KY, Lee HS, Hong JH, et all.Highdose intravenous immunoglobulin downregulates the activated levels of inflammatory indices except erythrocyte sedimentation rate in acute stage of Kawasaki Disease. J Trop Pediatr. 2005; 51:98-101.
• 8. Schussler O, Lantoine F, Devynck MA, et all. Human immunoglobulins inhibit thrombin-induced Ca movements and nitric oxide production in endothelial cells. J Biol Chem. 1996; 271:26473-26476.
• 9. Bagdasarian A, Tonetta S, Harel W, et all. IVIG adverse reactions: potential role of cytokines and vasoactive substances. Vox Sang. 1998; 74: 74-82.