Chronic Severe Neutropenia Associated With Intravenous Immunoglobulin for Multifocal Motor Neuropathy

EJHaem Pub Date : 2025-01-27 DOI:10.1002/jha2.1102
Shannon Ugarte, Talia Gebhard, David R. Cornblath, Steven S. Scherer, Daria V. Babushok
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Abstract

Intravenous immunoglobulin (IVIG) is an immunomodulatory therapy derived from pooled donor immunoglobulins and used for treatment of various autoimmune conditions. Here we report the diagnosis and management of IVIG-induced chronic severe neutropenia with absolute neutrophil count <0.5×103/µL in a patient with multifocal motor neuropathy. Serial blood count showed a cyclical pattern of neutropenia: worsening 24–48 h post-IVIG, then gradually improving before the next infusion. IVIG-induced neutropenia is rare, with previous reports of predominantly mild transient neutropenia. Our case describes chronic severe neutropenia that developed years after starting IVIG. We summarize available evidence and management strategies for IVIG-associated neutropenia.

Abstract Image

慢性严重中性粒细胞减少伴静脉注射免疫球蛋白治疗多灶性运动神经病。
静脉注射免疫球蛋白(IVIG)是一种源自供体免疫球蛋白的免疫调节疗法,用于治疗各种自身免疫性疾病。在这里,我们报告了一例多灶性运动神经病变患者的诊断和治疗,该患者为ivig诱导的慢性严重中性粒细胞减少症,绝对中性粒细胞计数为3/µL。系列血细胞计数显示中性粒细胞减少的周期性模式:ivig后24-48 h恶化,然后在下一次输注前逐渐改善。ivig诱导的中性粒细胞减少是罕见的,以前的报道主要是轻微的短暂性中性粒细胞减少。我们的病例描述了慢性严重中性粒细胞减少症,在开始IVIG后发展多年。我们总结了ivig相关的中性粒细胞减少症的现有证据和管理策略。
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