Stroke following intravenous immunoglobulin infusion in a 28-year-old male with common variable immune deficiency: A case report and literature review

We report a patient who developed left-sided hemiparesis, dysarthria, and dysphagia 26 hours post-intravenous immunoglobulin (IVIg) infusion for treatment of common variable immune deficiency (CVID). ACT and MRI scan of the brain showed multiple areas of new infarcts. A stroke etiology workup was unremarkable aside from a positive bubble study on ECHO suggesting a small atrial septal defect or a patent foramina ovale. A review of the literature found very few cases of strokes associated with IVIg use, and none with CVID. Possible mechanisms are suggested. We conclude that strokes are a potential complication of IVIg use in patients on replacement IVIg for CVID.