Acute haemolysis secondary to low dose of intravenous immunoglobulins.

ROZITA M, MOHAMAD FADLI AR, RIZNA AC

Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia

ABSTRACT

Intravenous immunoglobulin is beneficial in treating lupus nephritis at various stages of treatment. It is generally well tolerated with mild and transient side effects. We report a case of a young man with recalcitrant lupus nephritis who was treated with three courses of intravenous immunoglobulin of 100 grams, 60 grams and 15 grams respectively within 5 months. During the last course, he developed acute haemolysis on day 3 of treatment; haemoglobin dropped by 3 grams, elevated lactate dehydrogenase, reticulocytosis and haemoglobinuria. Full blood picture revealed typical haemolysis findings. Immediate improvement was observed after stopping the immunoglobulin and with transfusion of 2 pints of packed cell.

Keywords: systemic lupus erythematosus, lupus nephritis, immune thrombocytopenic purpura, immunoglobulin

Correspondence: Dr Rozita Mohd, Department of Medicine, PPUKM, Jalan Yaacob Latiff, Cheras, 56000 Kuala Lumpur, Malaysia.

Contact no: +60122022794, Fax no : +6091456934, Email : rozi8286@gmail.com

Brunei Int Med J. 2017; 13 (1): 33-35