All issues > Volume 43(5); 2000

Case Report

J Korean Pediatr Soc. 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 SW Park¹, Kyung-Yil KY Lee¹, Kyung-Yil KY Lee¹, Kye-Nam KN Yoon¹, Sang-Won SW Cha¹, Dong-Jun DJ Lee¹, Ji-Whan JW Han¹, Kyung-Tai KT Whang¹

¹Department of Pediatrics, College of Medicine, Catholic University of Korea

Correspondence Kyung-Yil KY 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.

Keywords :Acute renal failure, Intravenous immunoglobulin, Child, Kawasaki disease