Immune globulin
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Vasculopathy and multiple intracranial haemorrhages: case report A 3-year-old girl developed vasculopathy and multiple intracranial haemorrhages during treatment with immune globulin for Guillain-Barre syndrome (GBS). The girl was hospitalised due to bronchopneumonia and respiratory distress. Multiple analyses were performed, and on day 7 of hospitalisation, the diagnosis of GBS was confirmed. Therefore, she received IV immune globulin [dosage not stated] for 5 days. On day 10 of hospitalisation, she received phenytoin and levetiracetam for seizures. Midazolam was added since adequate control of seizures was not achieved. Brain CT and MRI showed a number of haemorrhagic regions predominantly in the cortical subcortical regions of the brain. Her vital signs were stable during follow-up. A vasculopathy was suspected; hence, she underwent angiography. The angiographic findings were consistent with vasculopathy. The girl received treatment with unspecified steroids for 10 days, after which they were gradually tapered. On day 24 of hospitalisation, she was able to move her legs. Midazolam and phenytoin were discontinued as seizures were not present. She was extubated in the second month of hospitalisation. Levetiracetam was discontinued due to normal electroencephalogram findings. Oral feeding was started. She was discharged to receive physical therapy for mild gait disturbance during the fourth month of hospitalisation. She eventually recovered without any sequelae. It was concluded that the treatment with immune globulin triggered the vasculopathy, which further resulted in intracranial haemorrhages [times to reactions onsets not clearly stated]. Isikay S, et al. Multiple cerebral hemorrhages during the course of Guillain-Barre syndrome: A case report. Journal of Pediatric Neurosciences 15: 105-107, No. 2, 30 Jun 803519007 2020. Available from: URL: http://doi.org/10.4103/jpn.JPN_143_18
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Reactions 5 Dec 2020 No. 1833
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