The brain in schizophrenia.

From these three reports, we conclude: 1 Intravenous immune globulin can induce aseptic meningitis in children as well as in adults: the strong temporal association (on day three in our patient and in Watson's patients) and the repetitive occurrence in the same patient (on two occasions in Kato's patient and in our patient) are both strong arguments in favour of this. It should no longer be a hypothesis. 2 Several preparations of intravenous immune globulin can induce aseptic meningitis. Up till now it has been reported with four different preparations: with immunoglobulin prepared with polyethylene glycol and with a sulphonated preparation,' with a formulation prepared by cold ethanol fractionation (San-doglobulin)' and with a low PH formulation prepared with ethylene glycol (Intragam).' 3 As with many other iatrogenic diseases, the aseptic meningitis in itself is rather benign and resolves rapidly with cessation of the therapy. But not recognising this complication as such might result in potentially dangerous and/or unnecessary explorations (lumber puncture in a thrombocytopenic patient;4 CT scan) The possible occurrence of aseptic meningitis following immune globulin infusion should thus be known by all physicians and should be mentioned by the pharmaceutical firms. meningitis associated with high dose intravenous immunoglobulin therapy. Dr Watson et al' described two patients who developed aseptic meningitis after high dose intravenous immunoglobulins (IgIV). Both had mild symptoms and recovered completely within 14 and seven days, respectively. We consider it important that this side effect has been noted. It improves detection of future similar effects and places it in the appropriate pathogenetic context. The observations on these two patients, however, do not give any clue about the incidence of this side effect. In the Dutch Multi Centre Guillain-Barre trial we compared high dose IgIV with plasma-exchange (PE). Based on the main outcome criterion-functional improvement four weeks after randomisation-IgIV was superior to PE.2 ' As a result of this study IgIV may well be used more often in neuro-logical patients after detailed publication of the results. We would therefore like to report our experiences on the side effects of IgIV. In 74 patients 0 4 g/kg of IgIV (Gamma-gardR, Hyland Division, Baxter) was infused during five consecutive days, a total of 370 infusions. These infusions were all performed during the acute phase of the Guillain-Barre syndrome in patients of all ages. During the infusion period patients were scored every other day and questions about complications were included in …