Abstract | OBJECTIVE: DESIGN: Retrospective analysis of a prospective cohort study. SETTING: Tertiary research referral center. PATIENTS: MEASUREMENTS: Analysis of patient records for evidence of aseptic meningitis, associated risk factors, penetration of serum IgG into the cerebrospinal fluid, and clearance of cerebrospinal fluid IgG. RESULTS: Of 54 patients, 6 (11%; 95% CI, 4% to 23%) developed aseptic meningitis within 24 hours after completion of the infusions. Symptoms, lasting 3 to 5 days, included severe headache, meningismus, photophobia, and fever. Cerebrospinal fluid showed pleocytosis in 4 patients (leukocyte count as high as 1169 x 10(6)/L in one patient), eosinophilia in 3 patients, and IgG elevation in all patients (as great as 7 times the upper limit of normal in one patient). Repeat cerebrospinal fluid and serum studies after 24 hours showed a 46% cerebrospinal fluid IgG clearance compared with an 11% clearance of serum IgG in one patient. Cerebrospinal fluid cultures were negative. Aseptic meningitis developed in 4 of 8 patients (50%; CI, 16% to 84%) with a history of migraine but in only 2 of 46 (4%; CI, 0.5% to 15%) patients without such a history (P = 0.003). Aseptic meningitis recurred in patients who had migraine despite the use of different commercial intravenous immunoglobulin preparations and slower rates of infusion. CONCLUSION:
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Authors | E A Sekul, E J Cupler, M C Dalakas |
Journal | Annals of internal medicine
(Ann Intern Med)
Vol. 121
Issue 4
Pg. 259-62
(Aug 15 1994)
ISSN: 0003-4819 [Print] United States |
PMID | 8037406
(Publication Type: Journal Article)
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Chemical References |
- Immunoglobulins, Intravenous
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Topics |
- Adolescent
- Adult
- Aged
- Child
- Disease Susceptibility
- Female
- Headache
(etiology)
- Humans
- Immunoglobulins, Intravenous
(administration & dosage, adverse effects)
- Male
- Meningitis, Aseptic
(etiology)
- Middle Aged
- Migraine Disorders
(complications)
- Prospective Studies
- Retrospective Studies
- Risk Factors
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