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American Journal of Neuroradiology 26:2311-2315, October 2005
© 2005 American Society of Neuroradiology

Case Report
BRAIN

Acute Encephalopathy Associated with Intravenous Immunoglobulin Therapy

Akihiko Wada, Rika Yoshida, Kazushige Oda, Eiji Fukuba, Nobue Uchida and Hajime Kitagaki

From the Department of Radiology, Faculty of Medicine, Shimane University, Izumo, Shimane, Japan

Address correspondence to Akihiko Wada, MD, Department of Radiology, Shimane University Faculty of Medicine, 89-1 Enya-cyo Izumo, Japan

Summary: Intravenous immunoglobulin therapy is useful against various immune system disorders and viral infections. It is generally safe, and serious adverse reactions are uncommon. We report a rare case of acute encephalopathy following intravenous immunoglobulin therapy for human herpes virus 6 infection in a child. MR imaging findings suggest that the dominant causative mechanism of acute encephalopathy is cytotoxic edema, and the findings indicate 2 primary mechanisms. Reversibility of the restriction of water diffusion (low apparent diffusion coefficient value) on diffusion-weighted MR imaging suggests intramyelinic edema in the myelin sheath, and an increase of glutamate and glutamine complex peak on MR spectroscopy suggests excitotoxic injury to the neurons and astrocytes.






Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X