[PAGID] IVIG and aseptic meningitis

[Richard L. Wasserman, M.D.,Ph.D.]

Tryptans can be very helpful both for treatment and prophylaxis. In 
three patients we have had to use IV DHEA as a premed. Tryptans are 
pretty benign in this setting but I'd try all the previous suggestions; 
change product, use sub q, oral or IV steroids as a pre and/or post me 
before DHEA.
Richard Wasserman
Dallas

Chris Seroogy wrote:


>Dear Colleagues,

>

>I have a question about management of aseptic meningitis and IVIG.

>

>We have a 5 y/o with chemotherapy-induced immunodeficiency who meets

>criteria for immunoglobulin replacement.  He just had his first infusion

>(400mg/kg gammagard S/D) which went well, but 48 hours later developed

>severe headache and stiff neck.  I did not evaluate him, but the heme/onc

>colleagues felt he had aseptic meningitis and this resolved with pain

>management.

>

>My question is what has worked for individuals to prevent/prophylaxis this

>side effect?  He needs the product and I am told subcutaneous is not an

>option since he will pull out the tubing and it would be too much of a time

>commitment for the family.  Thank you for any input!  Regards, Chris

>

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