[en bloc]

I'm curious if anyone has had confirmed aseptic meningitis due to IVIG (immediately after infusion)? If so, did you ever try to do infusions again?

I ask because I did IVIG for 11 years. After a short break to fight insurance, I restarted in 2007 and got aseptic meningitis on the second of the loading doses. My CSF white cell count was over 700, so certainly not a mild case.

I have just found out I have ganglionitis and IVIG might prove helpful to slow progression. Of course, I'm hesitant about trying it again after that incident, but might give it consideration if I knew others had successfully restarted infusions after having aseptic meningitis.

I tried to research cases where it was restarted, but no luck.

It will probably not be an option, but I figured it couldn't hurt to ask.

[mrsD]

There is a young man using IVIG on MG forum.

He developed aseptic meningitis early on in his infusions:

http://neurotalk.psychcentral.com/post720711-6.html

This study also suggests changing the product and/or lot used if aseptic meningitis occurs:

http://www.annals.org/content/121/4/259.full.pdf+html

This is not a recent paper tho.

[en bloc]

Originally Posted by mrsD

There is a young man using IVIG on MG forum.

He developed aseptic meningitis early on in his infusions:

http://neurotalk.psychcentral.com/post720711-6.html

This study also suggests changing the product and/or lot used if aseptic meningitis occurs:

http://www.annals.org/content/121/4/259.full.pdf+html

This is not a recent paper tho.

Thanks MrsD.

Very interesting article. I see where product/lot might make a difference, but I also noticed that it seems in cases where the blood/nerve barrier is impaired (as in patients with neuropathies, etc) the chance may increase. It also can increase in patients with migraines (which I do not have a history of).

It's something to think about and discuss with my neurologist (he's working me in this Friday). We may just go back to the high dose IV methylprednisolone or Cellcept to treat the Sjogren's in hopes to slow the progression of the ganglionitis.

[Yurk]

Here is another one:
Pubmed ID: 16391392
Clin Rev Allergy Immunol. 2005 Dec;29(3):173-84.
Intravenous immunoglobulin: adverse effects and safe administration.
Orbach H, Katz U, Sherer Y, Shoenfeld Y.

The authors say that slow infusion rate and hydration can reduce the likelihood of most side effects, including aceptic meningitis.

I talked to my doctor about extra hydration and she ordered 1 liter of saline solution to be given intravenously every day after the IVIg infusion. I am just curious to know, did your doctors give you any IV fluids?

Originally Posted by en bloc

Thanks MrsD.

Very interesting article. I see where product/lot might make a difference, but I also noticed that it seems in cases where the blood/nerve barrier is impaired (as in patients with neuropathies, etc) the chance may increase. It also can increase in patients with migraines (which I do not have a history of).

It's something to think about and discuss with my neurologist (he's working me in this Friday). We may just go back to the high dose IV methylprednisolone or Cellcept to treat the Sjogren's in hopes to slow the progression of the ganglionitis.

[en bloc]

Originally Posted by Yurk

Here is another one:
Pubmed ID: 16391392
Clin Rev Allergy Immunol. 2005 Dec;29(3):173-84.
Intravenous immunoglobulin: adverse effects and safe administration.
Orbach H, Katz U, Sherer Y, Shoenfeld Y.

The authors say that slow infusion rate and hydration can reduce the likelihood of most side effects, including aceptic meningitis.

I talked to my doctor about extra hydration and she ordered 1 liter of saline solution to be given intravenously every day after the IVIg infusion. I am just curious to know, did your doctors give you any IV fluids?

I always hydrated well prior to and after an infusion, but I had not used IV fluids. I may be starting IVIG again soon. If so, I will certainly keep the IV fluids in mind.