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A Case of Acute Renal Failure Following Intravenous Immunoglobulin Therapy in a Child

Journal of the Korean Pediatric Society 2000;43(5):720-724.
Published online May 15, 2000.
A Case of Acute Renal Failure Following Intravenous Immunoglobulin Therapy in a Child
Sung-Wook Park, Kyung-Yil Lee, Kyung-Yil Lee, Kye-Nam Yoon, Sang-Won Cha, Dong-Jun Lee, Ji-Whan Han, Kyung-Tai Whang
Department of Pediatrics, College of Medicine, Catholic University of Korea
소아에서 발생한 정맥용 면역글로불린 치료에 따른 급성 신부전 1례
박상욱, 이경일, 이주옥, 윤계남, 차상원, 이동준, 한지환, 황경태
가톨릭대학교 의과대학 소아과학교실
Correspondence: 
Kyung-Yil Lee, Email: leekyungyil@yahoo.com
Abstract
Intravenous immunoglobulin(IVIG) therapy is associated with a number of complications, including rare acute renal failure(ARF). Although the cause of IVIG-associated ARF is unknown, it may be related to the stabilizing agent used in IVIG preparations. ARF following IVIG infusion has not been previously described in children. We report a 4-year-old girl with Kawasaki disease who suffered from ARF following IVIG containing maltose. The previously healthy child had no underlying renal disease. She was given a 2g/kg body weight of IVIG(I.V.-Globulin S, Green Cross, IgG : maltose=1 : 2) for 10 hours. From the second day of IVIG administration, a gradual reduction of daily urine output was observed with an increase of BUN and creatinine levels, which by the fourth day of treatment reached 43.8mg/dL and 4.7mg/dL, respectively. A conservative ARF treatment resulted in a gradual increase in urine output, together with a decrease in BUN and creatinine levels, which after 7 days returned to normal levels. In view of the increasing use of IVIG in medicine, it is imperative that clinicians be aware of this unusual form of renal injury.
Key Words: Acute renal failure, Intravenous immunoglobulin, Child, Kawasaki disease


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