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Clinical Reviews in Allergy & Immunology

Open Access 13-05-2024 | Meningitis | Review

Acute Aseptic Meningitis Temporally Associated with Intravenous Polyclonal Immunoglobulin Therapy: A Systematic Review

Authors: Elisabetta L.T. De Felice, Gabriel F. Toti, Beatrice Gatti, Renato Gualtieri, Pietro Camozzi , Sebastiano A.G. Lava, Gregorio P. Milani, Giorgio Treglia, Federica Vanoni, Mario G. Bianchetti, Gianmaria F. Bernasconi, Benedetta Terziroli Beretta Piccoli, Camilla Lavagno

Published in: Clinical Reviews in Allergy & Immunology

Abstract

An acute aseptic meningitis has been occasionally observed on intravenous polyclonal human immunoglobulin therapy. Since case reports cannot be employed to draw inferences about the relationships between immunoglobulin therapy and meningitis, we conducted a systematic review and meta-analysis of the literature. Eligible were cases, case series, and pharmacovigilance studies. We found 71 individually documented cases (36 individuals ≤ 18 years of age) of meningitis. Ninety percent of cases presented ≤ 3 days after initiating immunoglobulin therapy and recovered within ≤ 7 days (with a shorter disease duration in children: ≤ 3 days in 29 (94%) cases). In 22 (31%) instances, the authors noted a link between the onset of meningitis and a rapid intravenous infusion of immunoglobulins. Cerebrospinal fluid analysis revealed a predominantly neutrophilic (N = 46, 66%) pleocytosis. Recurrences after re-exposure were observed in eight (N = 11%) patients. Eight case series addressed the prevalence of meningitis in 4089 patients treated with immunoglobulins. A pooled prevalence of 0.6% was noted. Finally, pharmacovigilance data revealed that meningitis temporally associated with intravenous immunoglobulin therapy occurred with at least five different products. In conclusion, intravenous immunoglobulin may cause an acute aseptic meningitis. The clinical features remit rapidly after discontinuing the medication.

Hasbun R (2000) The acute aseptic meningitis syndrome. Curr Infect Dis Rep 2:345–351. https://doi.org/10.1007/s11908-000-0014-zCrossRefPubMed

Lee BE, Davies HD (2007) Aseptic meningitis. Curr Opin Infect Dis 20:272–277. https://doi.org/10.1097/QCO.0b013e3280ad4672CrossRefPubMed

Wallgren A (1924) Une nouvelle maladie infectieuse du système nerveux central? méningite aseptique aiguë. Acta Paediatr 4:158–182. https://doi.org/10.1111/j.1651-2227.1924.tb17242.xCrossRef

Perez EE, Orange JS, Bonilla F, Chinen J, Chinn IK, Dorsey M, El-Gamal Y, Harville TO, Hossny E, Mazer B, Nelson R, Secord E, Jordan SC, Stiehm ER, Vo AA, Ballow M (2017) Update on the use of immunoglobulin in human disease: a review of evidence. J Allergy Clin Immunol 139:S1–S46. https://doi.org/10.1016/j.jaci.2016.09.023CrossRefPubMed

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, Moher D (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. J Clin Epidemiol 134:178–189. https://doi.org/10.1016/j.jclinepi.2021.03.001CrossRefPubMed

Hanly JG, Urowitz MB, Gordon C, Bae SC, Romero-Diaz J, Sanchez-Guerrero J, Bernatsky S, Clarke AE, Wallace DJ, Isenberg DA, Rahman A, Merrill JT, Fortin PR, Gladman DD, Bruce IN, Petri M, Ginzler EM, Dooley MA, Ramsey-Goldman R, Manzi S, Jönsen A, Alarcón GS, van Vollenhoven RF, Aranow C, Mackay M, Ruiz-Irastorza G, Lim S, Inanc M, Kalunian KC, Jacobsen S, Peschken CA, Kamen DL, Askanase A, Farewell V (2020) Neuropsychiatric events in systemic lupus erythematosus: a longitudinal analysis of outcomes in an international inception cohort using a multistate model approach. Ann Rheum Dis 79:356–362. https://doi.org/10.1136/annrheumdis-2019-216150CrossRefPubMed

Jolles S, Sewell WA, Leighton C (2000) Drug-induced aseptic meningitis: diagnosis and management. Drug Saf 22:215–226. https://doi.org/10.2165/00002018-200022030-00005CrossRefPubMed

Vismara SA, Lava SAG, Kottanattu L, Simonetti GD, Zgraggen L, Clericetti CM, Bianchetti MG, Milani GP (2020) Lipschütz’s acute vulvar ulcer: a systematic review. Eur J Pediatr 179:1559–1567. https://doi.org/10.1007/s00431-020-03647-yCrossRefPubMed

Papageorgiou G, Grant SW, Takkenberg JJM, Mokhles MM (2018) Statistical primer: how to deal with missing data in scientific research? Interact Cardiovasc Thorac Surg 27:153–158. https://doi.org/10.1093/icvts/ivy102CrossRefPubMed

10.

Brown GW, Hayden GF (1985) Nonparametric methods Clinical applications Clin Pediatr (Phila) 24:490–498. https://doi.org/10.1177/000992288502400905CrossRefPubMed

11.

Moses LE, Emerson JD, Hosseini H (1984) Analyzing data from ordered categories. N Engl J Med 311:442–448. https://doi.org/10.1056/NEJM198408163110705CrossRefPubMed

12.

Kato E, Shindo S, Eto Y, Hashimoto N, Yamamoto M, Sakata Y, Hiyoshi Y (1988) Administration of immune globulin associated with aseptic meningitis. JAMA 259:3269–3271. https://doi.org/10.1001/jama.1988.03720220017010CrossRefPubMed

13.

Casteels-Van Daele M, Wijndaele L, Hanninck K, Gillis P (1990) Intravenous immune globulin and acute aseptic meningitis. N Engl J Med 323:614–615. https://doi.org/10.1056/NEJM199008303230917CrossRefPubMed

14.

Watson JD, Gibson J, Joshua DE, Kronenberg H (1991) Aseptic meningitis associated with high dose intravenous immunoglobulin therapy. J Neurol Neurosurg Psychiatry 54:275–276. https://doi.org/10.1136/jnnp.54.3.275CrossRefPubMedPubMedCentral

15.

Kressebuch H, Schaad UB, Hirt A, Bianchetti MG (1992) Cerebrospinal fluid inflammation induced by intravenous immunoglobulins. Pediatr Infect Dis J 11:894–895. https://doi.org/10.1097/00006454-199210000-00020CrossRefPubMed

16.

Molina JM, Coffineau A, Rain JD, Letonturier D, Modaï J (1992) Aseptic meningitis following administration of intravenous immune globulin. Clin Infect Dis 15:564–565. https://doi.org/10.1093/clind/15.3.564CrossRefPubMed

17.

Mselati JC, Carlier JC, Routon MC, Noui Mehidi F, de Gennes C (1992) Immunoglobulines intraveineuses et méningite aseptique [Intravenous immunoglobulins and aseptic meningitis]. Arch Fr Pédiatr Mar 49:216

18.

Pallares DE, Marshall GS (1992) Acute aseptic meningitis associated with administration of intravenous immune globulin. Am J Pediatr Hematol Oncol 14:279. https://doi.org/10.1097/00043426-199208000-00019CrossRefPubMed

19.

Rao SP, Teitlebaum J, Miller ST (1992) Intravenous immune globulin and aseptic meningitis. Am J Dis Child 146:539–540. https://doi.org/10.1001/archpedi.1992.02160170019004CrossRefPubMed

20.

Vera-Ramirez M, Charlet M, Parry GJ (1992) Recurrent aseptic meningitis complicating intravenous immunoglobulin therapy for chronic inflammatory demyelinating polyradiculoneuropathy. Neurology 42:1636–1637. https://doi.org/10.1212/wnl.42.8.1636-aCrossRefPubMed

21.

Meiner Z, Ben-Hur T, River Y, Reches A (1993) Aseptic meningitis as complication of intravenous immunoglobulin therapy for myasthenia gravis. J Neurol Neurosurg Psychiatry 56:830–831. https://doi.org/10.1136/jnnp.56.7.830-aCrossRefPubMedPubMedCentral

22.

Mitterer M, Pescosta N, Vogetseder W, Mair M, Coser P (1993) Two episodes of aseptic meningitis during intravenous immunoglobulin therapy of idiopathic thrombocytopenic purpura. Ann Hematol 67:151–152. https://doi.org/10.1007/BF01701743CrossRefPubMed

23.

De Vlieghere FC, Peetermans WE, Vermylen J (1994) Aseptic granulocytic meningitis following treatment with intravenous immunoglobulin. Clin Infect Dis 18:1008–1010. https://doi.org/10.1093/clinids/18.6.1008CrossRefPubMed

24.

Ellis RJ, Swendson MR, Bajorek J (1994) Aseptic meningitis as a complication of intravenous immunoglobulin therapy for myasthenia gravis. Muscle Nerve 17:683–684. https://doi.org/10.1002/mus.880170620CrossRefPubMed

25.

Sekul EA, Cupler EJ, Dalakas MC (1994) Aseptic meningitis associated with high-dose intravenous immunoglobulin therapy: frequency and risk factors. Ann Intern Med 121:259–262. https://doi.org/10.7326/0003-4819-121-4-199408150-00004CrossRefPubMed

26.

FernándezCarril JM, Trejo JM, Sedano MJ, Goñi M (1995) Aseptic meningitis caused by intravenous immunoglobulin. Neurologia 10:351–352

27.

Gabor EP (1995) Intravenous immune globulin. West J Med 162:277–278PubMedPubMedCentral

28.

Oddou S, Molinier S, Coso D, Boulet JM, Gastaut JA, Bouabdallah R (1995) Méningite aseptique consécutive à un traitement par immunoglobulines: intérêt physiopathologique et prognostique de son dépistage [Aseptic meningitis following treatment with immunoglobulins: physiopathological and prognostic value of screening]. Presse Med 24:916PubMed

29.

Preminger-Shapiro R, Nussinovitch M, Soen G, Varsano I (1995) Aseptic meningitis: a frequent side-effect of intravenous immunoglobulin? Eur J Pediatr 154:866–767. https://doi.org/10.1007/BF01959803CrossRefPubMed

30.

Shorr AF, Kester KE (1996) Meningitis and hepatitis complicating intravenous immunoglobulin therapy. Ann Pharmacother 30:1115–1116. https://doi.org/10.1177/106002809603001010CrossRefPubMed

31.

Sirvent N, Monpoux F, Benet L, Mariani R (1996) Méningite aseptique au cours d’un traitement par immunoglobulines [Aseptic meningitis during treatment with immunoglobulins]. Arch Pédiatr 3:830–831. https://doi.org/10.1016/0929-693x(96)82172-5CrossRefPubMed

32.

Lafferty TE, DeHoratius RJ, Smith JB (1997) Aseptic meningitis as a side effect of intravenous immune gammaglobulin. J Rheumatol 24:2491–2492PubMed

33.

Picton P, Chisholm M (1997) Aseptic meningitis associated with high dose immunoglobulin: case report. BMJ 315:1203–1204. https://doi.org/10.1136/bmj.315.7117.1203CrossRefPubMedPubMedCentral

34.

Boyce TG, Spearman P (1998) Acute aseptic meningitis secondary to intravenous immunoglobulin in a patient with Kawasaki syndrome. Pediatr Infect Dis J 17:1054–1056. https://doi.org/10.1097/00006454-199811000-00023CrossRefPubMed

35.

Al-Ghamdi H, Mustafa MM, Al-Fawaz I, Al-Dowaish A (1999) Acute aseptic meningitis associated with administration of immunoglobulin in children: a case report and review of the literature. Ann Saudi Med 19:362–364. https://doi.org/10.5144/0256-4947.1999.362CrossRefPubMed

36.

Piguet C, Fontmarty S, Gilbert B, Vodoff MV, de Lumley L (1999) Purpura thrombopénique idiopathique, immunoglobulines intraveineuses et méningite aseptique [Idiopathic thrombopenic purpura, intravenous immunoglobulins and aseptic meningitis]. Arch Pediatr 6:1350–1351. https://doi.org/10.1016/s0929-693x(00)88905-8CrossRefPubMed

37.

Nelson MA, Carregal VA, DeGuzman RD, Engler RJM (2000) Aseptic meningitis due to intravenous immunoglobulin therapy that resolved with subcutaneous administration. Pediatr Allergy Immunol Pulmonol 14:323–327. https://doi.org/10.1089/088318700750070420CrossRef

38.

Obando I, Duran I, Martin-Rosa L, Cano JM, Garcia-Martin FJ (2002) Aseptic meningitis due to administration of intravenous immunoglobulin with an unusually high number of leukocytes in cerebrospinal fluid. Pediatr Emerg Care 18:429–432. https://doi.org/10.1097/00006565-200212000-00006CrossRefPubMed

39.

Wright SE, Shaikh ZH, Castillo-Lugo JA, Tanriover B (2008) Aseptic meningitis and abducens nerve palsy as a serious side effect of high dose intravenous immunoglobulin used in a patient with renal transplantation. Transpl Infect Dis 10:294–297. https://doi.org/10.1111/j.1399-3062.2007.00294.xCrossRefPubMed

40.

Asano T, Koizumi S, Mishina-Ikegami K, Hatori T, Miyasho T, Fujino O (2010) Increased levels of monocyte chemoattractant protein-1 in cerebrospinal fluid with gamma globulin induced meningitis. Acta Paediatr 99:164–165. https://doi.org/10.1111/j.1651-2227.2009.01550.xCrossRefPubMed

41.

García Norniella B, Morán Poladura M, Fernández Díaz M, Fernández Fernández E, Suárez Castañón C (2011) Meningitis aséptica secundaria a tratamiento con inmunoglobulina intravenosa en la enfermedad de Kawasaki [Aseptic meningitis secondary to intravenous immunoglobulin treatment in Kawasaki disease]. An Pediatr (Barc) 75:79–80. https://doi.org/10.1016/j.anpedi.2010.11.019CrossRefPubMed

42.

Kaarthigeyan K, Burli VV (2011) Aseptic meningitis following intravenous immunoglobulin therapy of common variable immunodeficiency. J Pediatr Neurosci 6:160–161. https://doi.org/10.4103/1817-1745.92858CrossRefPubMedPubMedCentral

43.

Kemmotsu Y, Nakayama T, Matsuura H, Saji T (2011) Clinical characteristics of aseptic meningitis induced by intravenous immunoglobulin in patients with Kawasaki disease. Pediatr Rheumatol Online J 9:28. https://doi.org/10.1186/1546-0096-9-28CrossRefPubMedPubMedCentral

44.

Chaabane A, Hamzaoui A, Aouam K, Klai R, Fredj NB, Boughattas NA, Mahjoub S (2012) Human intravenous immunoglobulin-induced aseptic meningitis: a case report. J Clin Pharmacol 52:279–281. https://doi.org/10.1177/0091270010394183CrossRefPubMed

45.

Mullane D, Williams L, Merwick A, Tobin WO, McGuigan C (2012) Drug induced aseptic meningitis caused by intravenous immunoglobulin therapy. Ir Med J 105:182–183PubMed

46.

Ventura F, Rocha J, Fernandes JC, Machado A, Brito C (2013) Recalcitrant pemphigus vulgaris: aseptic meningitis associated with intravenous immunoglobulin therapy and successful treatment with rituximab. Int J Dermatol 52:501–502. https://doi.org/10.1111/j.1365-4632.2010.04870.xCrossRefPubMed

47.

Jain RS, Kumar S, Aggarwal R, Kookna JC (2014) Acute aseptic meningitis due to intravenous immunoglobulin therapy in Guillain-Barré syndrome. Oxf Med Case Reports 2014:132–134. https://doi.org/10.1093/omcr/omu051CrossRefPubMedPubMedCentral

48.

Bharath V, Eckert K, Kang M, Chin-Yee IH, Hsia CC (2015) Incidence and natural history of intravenous immunoglobulin-induced aseptic meningitis: a retrospective review at a single tertiary care center. Transfusion 55:2597–2605. https://doi.org/10.1111/trf.13200CrossRefPubMed

49.

Puy-Nunez A, Dacosta-Balboa M, Cabo-Lopez I, Canneti B, Lopez-Ferreiro A, Rodriguez-Alvarez JR, Rodriguez-Regal A, Mourino-Sestelo MA (2016) Meningitis aseptica como complicaciòn del tratamiento con inmunoglobulinas en la miastenia grave [Aseptic meningitis as a complication of immunoglobulin treatment in myasthenia gravis]. Rev Neurol 62:478–479PubMed

50.

Kumar PA, SubhalaxamiMargekar S (2017) Aseptic meningitis complicating immunoglobulin therapy in AIDP. Pol Ann Med 24:52–54. https://doi.org/10.1016/j.poamed.2016.03.004CrossRef

51.

Patel A, Potu KC, Sturm T (2017) A case of IVIG-induced aseptic chemical meningitis. S D Med 70:119–121PubMed

52.

Wanigasekera T, Grainger RJ, Sexton DJ, Magee C (2017) IVIG associated aseptic meningitis in a renal transplant patient. Case Rep Transplant 2017:6962150. https://doi.org/10.1155/2017/6962150CrossRefPubMedPubMedCentral

53.

Graça L, Alves J, Nuak J, Sarmento A (2018) Immunoglobulin-induced aseptic meningitis: a case report. BMC Neurol 18:97. https://doi.org/10.1186/s12883-018-1102-8CrossRefPubMedPubMedCentral

54.

Vassalini P, Ajassa C, Di Ruscio V, Morace A, Vergari J, Tosato C, Savelloni G, Mastroianni CM (2019) Aseptic meningitis induced by intravenous immunoglobulins in a child with acute Epstein-Barr virus infection and thrombocytopenia. Infez Med 27:194–197PubMed

55.

Maldonado Slootjes S, Guilmot A, Dubuisson N, van Pesch V, Elsankari S (2020) Intravenous immunoglobulin-induced aseptic meningitis in a patient with Miller Fisher syndrome. Acta Neurol Belg 120:1015–1016. https://doi.org/10.1007/s13760-020-01389-0CrossRefPubMed

56.

Vargas PD, Moreno MA (2021) Meningitis aséptica secundaria a la administración de inmunoglobulina. Rpert Med Cir 30:170–172. https://doi.org/10.31260/RepertMedCir.01217372.899CrossRef

57.

Chan OM, Kuok CI, Chan KYW, Yeung HMR (2022) Immunoglobulin-induced aseptic meningitis in juvenile dermatomyositis: a case report. Cureus 14:e31808. https://doi.org/10.7759/cureus.31808CrossRefPubMedPubMedCentral

58.

Russo CC, Dalton LK, Grant L, Enos N, Evans DLA (2022) Patient with severe headache after IV immunoglobulin. Fed Pract 39:487–489. https://doi.org/10.12788/fp.0342CrossRefPubMedPubMedCentral

59.

Young CC, LaRovere KL, Newhams MM, Kucukak S, Gertz SJ, Maddux AB, Halasa NB, Crandall H, Kong M, Fitzgerald JC, Irby K, Randolph AG, Campbell AP, Son MBF (2023) Overcoming COVID-19 Investigators. Clinical course associated with aseptic meningitis induced by intravenous immunoglobulin for the treatment of multisystem inflammatory syndrome in children. J Pediatr 257:113372. https://doi.org/10.1016/j.jpeds.2023.01.025CrossRefPubMed

60.

Brannagan TH 3rd, Nagle KJ, Lange DJ, Rowland LP (1996) Complications of intravenous immune globulin treatment in neurologic disease. Neurology 47:674–677. https://doi.org/10.1212/wnl.47.3.674CrossRefPubMed

61.

Kattamis AC, Shankar S, Cohen AR (1997) Neurologic complications of treatment of childhood acute immune thrombocytopenic purpura with intravenously administered immunoglobulin G. J Pediatr 130:281–283. https://doi.org/10.1016/s0022-3476(97)70355-xCrossRefPubMed

62.

Sherer Y, Levy Y, Langevitz P, Rauova L, Fabrizzi F, Shoenfeld Y (2001) Adverse effects of intravenous immunoglobulin therapy in 56 patients with autoimmune diseases. Pharmacology 62:133–137. https://doi.org/10.1159/000056085CrossRefPubMed

63.

Stangel M, Kiefer R, Pette M, Smolka MN, Marx P, Gold R (2003) Side effects of intravenous immunoglobulins in neurological autoimmune disorders - a prospective study. J Neurol 250:818–821. https://doi.org/10.1007/s00415-003-1085-1CrossRefPubMed

64.

Berg R, Fuellenhals E (2016) Aseptic meningitis following therapy with immune globulins: a combination of product features and patient characteristics? Transfusion 56:3021–3028. https://doi.org/10.1111/trf.13886CrossRefPubMed

65.

Bihan K, Weiss N, Théophile H, Funck-Brentano C, Lebrun-Vignes B (2019) Drug-induced aseptic meningitis: 329 cases from the French pharmacovigilance database analysis. Br J Clin Pharmacol 85:2540–2546. https://doi.org/10.1111/bcp.14073CrossRefPubMedPubMedCentral

66.

Re VL 3rd, Gluckman SJ (2003) Eosinophilic meningitis. Am J Med 114:217–223. https://doi.org/10.1016/s0002-9343(02)01495-xCrossRefPubMed

67.

Morell A (1986) Various immunoglobulin preparations for intravenous use. Vox Sang 51(Suppl 2):44–49. https://doi.org/10.1111/j.1423-0410.1986.tb02007.xCrossRefPubMed

68.

Dantal J (2013) Intravenous immunoglobulins: in-depth review of excipients and acute kidney injury risk. Am J Nephrol 38(4):275–284. https://doi.org/10.1159/000354893CrossRefPubMed

69.

Bagos-Estevez AG, Ledford DK (2022) Anaphylaxis: definition, epidemiology, diagnostic challenges, grading system. Immunol Allergy Clin North Am 42:1–11. https://doi.org/10.1016/j.iac.2021.09.001CrossRefPubMed

70.

Lawley TJ, Bielory L, Gascon P, Yancey KB, Young NS, Frank MM (1984) A prospective clinical and immunologic analysis of patients with serum sickness. N Engl J Med 311:1407–1413. https://doi.org/10.1056/NEJM198411293112204CrossRefPubMed

71.

Veranneman N, Van Raemdonck D, Dupont L, Verleden G (2010) Repeated, severe headache in a lung transplant patient: a case report. Acta Clin Belg 65:269–270. https://doi.org/10.1179/acb.2010.057CrossRefPubMed

72.

Cherin P, Marie I, Michallet M, Pelus E, Dantal J, Crave JC, Delain JC, Viallard JF (2016) Management of adverse events in the treatment of patients with immunoglobulin therapy: a review of evidence. Autoimmun Rev 15:71–81. https://doi.org/10.1016/j.autrev.2015.09.002CrossRefPubMed

73.

Kretowska-Grunwald A, Krawczuk-Rybak M, Sawicka-Zukowska M (2022) Intravenous immunoglobulin-induced aseptic meningitis-a narrative review of the diagnostic process, pathogenesis, preventative measures and treatment. J Clin Med 11:3571. https://doi.org/10.3390/jcm11133571CrossRefPubMedPubMedCentral

Title: Acute Aseptic Meningitis Temporally Associated with Intravenous Polyclonal Immunoglobulin Therapy: A Systematic Review
Authors: Elisabetta L.T. De Felice
Gabriel F. Toti
Beatrice Gatti
Renato Gualtieri
Pietro Camozzi
Sebastiano A.G. Lava
Gregorio P. Milani
Giorgio Treglia
Federica Vanoni
Mario G. Bianchetti
Gianmaria F. Bernasconi
Benedetta Terziroli Beretta Piccoli
Camilla Lavagno
Publication date: 13-05-2024
Publisher: Springer US
Keyword: Meningitis
Published in: Clinical Reviews in Allergy & Immunology
Print ISSN: 1080-0549
Electronic ISSN: 1559-0267
DOI: https://doi.org/10.1007/s12016-024-08989-1

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