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February 26, 2026Internal Medicine0 citationsOpen Access

Embolic Ischemic Stroke Associated with Maintenance Intravenous Immunoglobulin Therapy

RMRyoji MiyanoYYYu YoshidaKFKazuki Fujita

Key Result

Maintenance intravenous immunoglobulin therapy in a 51-year-old patient with CIDP was associated with embolic ischemic stroke despite absence of conventional stroke risk factors.

Key Points

  • To report a unique case of embolic ischemic stroke associated with long-term IVIG therapy for CIDP.
  • Case report of a 51-year-old man
  • Detailed assessment of IVIG therapy history
  • Brain MRI conducted to identify stroke
  • Patient experienced an embolic ischemic stroke after the 112th IVIG infusion
  • Brain MRI confirmed an acute embolic infarction
  • No identified risk factors or embolic sources for ischemic stroke

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P
Population
51-year-old Japanese man with an 8-year history of typical chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and no conventional risk factors for ischemic stroke (n=1).
I
Intervention
Maintenance intravenous immunoglobulin (IVIG) therapy (0.6 g/kg/day, 10% concentration every 5 weeks).
O
Outcome
Acute embolic ischemic strokesafety

Embolic stroke may occur even in relatively younger, low-risk patients during uneventful maintenance IVIG therapy, warranting continued vigilance.

Limitations

  • Single patient case report limits generalizability
  • No control group or statistical comparison
  • Etiology uncertain due to possible contribution of antiphospholipid antibodies
  • No direct mechanistic evidence linking IVIG to embolism in this patient

Abstract

We describe the case of a 51-year-old man who experienced an embolic ischemic stroke during long-term maintenance of intravenous immunoglobulin (IVIG) therapy for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). At 43 years of age, he was diagnosed with CIDP and had tolerated IVIG well. Immediately after completing the 112th infusion, he exhibited acute right-hand clumsiness. Brain magnetic resonance imaging revealed an acute embolic infarction, and neither risk factors for ischemic stroke nor alternative embolic sources were identified. Although IVIG is generally considered safe, this case highlights that embolic stroke may occur even in relatively younger, low-risk patients during uneventful maintenance IVIG therapy, warranting continued vigilance.

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Cite This Study

Miyano et al. (2026) conducted a case report in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) (n=1). maintenance intravenous immunoglobulin (IVIG) therapy was evaluated on occurrence of embolic ischemic stroke during maintenance IVIG therapy. Maintenance intravenous immunoglobulin therapy in a 51-year-old patient with CIDP was associated with embolic ischemic stroke despite absence of conventional stroke risk factors.

synapsesocial.com/papers/699fe28895ddcd3a253e6549https://doi.org/10.2169/internalmedicine.6976-25
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