Lupus, Vol. 13, No. 6, 478-480 (2004)
DOI: 10.1191/0961203303lu1035cr
© 2004 SAGE Publications
IVIG treatment for progressive stroke in the primary antiphospholipid antibody syndrome
H C Horn
Department of Internal Medicine C, Section of Rheumatology, Odense University Hospital, hc.horn@dadlnet.dk
K Grau
Department of Internal Medicine, Kolding Sygehus, Denmark
P Junker
Department of Internal Medicine C, Section of Rheumatology, Odense University Hospital
A 32-year old woman with antiphospholipid antibody syndrome (APS) developed severe thrombocytopenia, elevated liver enzymes and progressive cerebral thrombosis a few days after preterm delivery by caesarean section. Her condition deteriorated despite treatment with low dose aspirin, anticoagulation by heparin and iv glucocorticoid administration. Intravenous immunoglobulin (IVIG) on three consecutive days was followed by rapid resolution of her neurological impairment and increasing platelets counts. The temporal association between IVIG and reversal of both neurological impairment and platelet number strongly indicates a specific effect of IVIG administration in this condition. It is proposed that IVIG therapy is considered as a therapeutic option in APS patients with progressive cerebral infarction despite optimal use of anticoagulant and immunomodulating agents.
Key Words: antiphospholipid antibody syndrome • intravenous immunoglobulin • stroke in progression