Clinical characteristics of aseptic meningitis induced by intravenous immunoglobulin in patients with Kawasaki disease

Background: aseptic meningitis is a serious adverse reaction to intravenous immunoglobulin (ivig) therapy. we studied the clinical characteristics of patients with acute kawasaki disease (kd) who developed ivig-induced aseptic meningitis.methods: a retrospective analysis of the medical records of patients with kd who developed aseptic meningitis after ivig treatment was performed.results: during the 10-year period from 2000 through 2009,among a total of 384 patients with kawasaki disease,4 (3 females and 1 male; age range,19-120 months) developed aseptic meningitis after ivig. all 4 developed aseptic meningitis within 48 hours (range,25-40 hours) of initiation of ivig. the analyses of cerebrospinal fluid (csf) revealed elevated white blood cell counts (22-1,248/μl) in all 4 patients; a predominance of polynuclear cells (65%-89%) was noted in 3. the csf protein level was elevated in only 1 patient (59 mg/dl),and the glucose levels were normal in all 4 patients. two patients were treated with intravenous methylprednisolone; the other 2 children were observed carefully without any special therapy. all patients recovered without neurological complications.conclusions: in our patients with kawasaki disease,aseptic meningitis induced by ivig occurred within 48 hours after initiation of ivig,resolved within a few days,and resulted in no neurological complications,even in patients who did not receive medical treatment. © 2011 kemmotsu et al; licensee biomed central ltd.