Transverse spinal cord infarction following immunoglobulin treatment in a patient with exfoliative dermatitis: A case report

Abstract

Rationale: Transverse spinal cord infarction (SCI) is rare but highly disabling. Aortic thrombosis was described as one of the most common etiologies. Thromboembolic complications associated with intravenous immunoglobulin (IVIG) have been reported. Patient concerns: A previously well, 64-year-old man who was given the treatment of IVIG (0.4 g/kg/d for 5 days) for exfoliative dermatitis 2 weeks before, progressively developed flaccid paraplegia of lower extremities, loss of all sensations below T3 level and urinary incontinence within 50 minutes. Diagnoses: A diagnosis of SCI and pulmonary embolism was made. IVIG was considered the possible cause. Interventions: Anticoagulation treatment and continuous rehabilitation were administered. Outcomes: The neurologic deficiency of the patient was partially improved at the 3-year follow-up. Lessons: The rapid development of severe deficits within 4 hours mostly contributes to the diagnosis of SCI. Heightened awareness of possible thrombotic events is encouraged for a month-long period following IVIG therapy.