Researchers Uncover Link Between Stroke and Common Treatment

June 19, 2003

Researchers at Wake Forest University School of Medicine have discovered that a relatively common treatment for a diverse group of diseases may induce stroke in a small percentage of the population. Results of the study, a retrospective review of patient cases, are published in the June 9 issue of Neurology.

The report describes sixteen patients being treated at Wake Forest and several other regional medical centers who had a stroke during, or shortly after, the administration of intravenous immunoglobulin (IVIG), which is used in the treatment of a variety of neurologic and blood disorders.

“There have been scattered reports of stroke associated with the infusion of IVIG since the mid-80’s, but this is the largest collection of cases and the first thorough inspection of the clinical features of these strokes,” said James Caress, M.D., assistant professor of neurology and lead investigator of the study.

Fourteen patients experienced stroke during or within 24 hours of an IVIG infusion and the remainder of the strokes occurred within four days of completing a course of treatment. The strokes varied in location and severity, and clinical improvement proceeded as would be expected from the size and location of each patient’s stroke.

“While the percentage of patients suffering stroke as a result of IVIG is small, the results of our study indicate further research should be taken to improve our understanding of why strokes occur following IVIG treatment so that we can identify patients at high risk and prevention this complication,” said Caress.

Stroke is an uncommon complication of IVIG treatment, which can be administered at home or in the hospital. The proportion of individuals who suffered a stroke among all patients who received inpatient IVIG treatment during a four-year period was 0.6%. The researchers suggest that the percentage might overestimate the average risk because hospitalized patients are more likely to be older and have more risk factors for stroke than non-hospitalized patients.

Fifteen of the sixteen patients had one or more risk factors for stroke, which include hypertension, diabetes mellitus, and previously known asymptomatic cerebrovascular disease or stroke. ###

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