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Neurology 2002;59:458-461
© 2002 American Academy of Neurology
Brief Communications

Neuropathologic findings in a Guillain–Barré patient with strokes after IVIg therapy

N. P. Byrne, MD, J. C. Henry, MD, D. N. Herrmann, MB, BCh, A. N. Abdelhalim, MD, D. A. Shrier, MD, C. W. Francis, MD and J. M. Powers, MD

From the Departments of Pathology and Laboratory Medicine (Neuropathology) (Drs. Powers, Herrmann, and Byrne), Neurology (Drs. Henry and Herrmann), Radiology (Drs. Abdelhalim and Shrier), and Medicine (Vascular Medicine) (Dr. Francis), University of Rochester School of Medicine and Dentistry, NY.

Address correspondence and reprint requests to Dr. James M. Powers, University of Rochester Medical Center, Department of Pathology and Laboratory Medicine, 601 Elmwood Avenue, Rochester, NY 14642; e-mail: james_powers{at}urmc.rochester.edu

Strokes have been rarely associated with immunoglobulin G (IVIg) therapy. A 70-year-old woman with stable polycythemia vera developed Guillain–Barré syndrome and received IVIg, 8 days following which she became comatose due to bilaterally symmetric cerebral infarcts. Autopsy showed intravascular aggregates of fibrin-IgG but also platelets and a necrotizing microangiopathy in the infarcts.




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