Clinical Course Associated with Aseptic Meningitis Induced by Intravenous Immunoglobulin for the Treatment of Multisystem Inflammatory Syndrome in Children

Cameron C Young; Kerri L LaRovere; Margaret M Newhams; Suden Kucukak; Shira J Gertz; Aline B Maddux; Natasha B Halasa; Hillary Crandall; Michele Kong; Julie C Fitzgerald; Katherine Irby; Adrienne G Randolph; Angela P Campbell; Mary Beth F Son; Overcoming COVID-19 Investigators

doi:10.1016/j.jpeds.2023.01.025

Clinical Course Associated with Aseptic Meningitis Induced by Intravenous Immunoglobulin for the Treatment of Multisystem Inflammatory Syndrome in Children

J Pediatr. 2023 Jun:257:113372. doi: 10.1016/j.jpeds.2023.01.025. Epub 2023 Mar 3.

Authors

Affiliations

¹ Division of Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA.
² Department of Neurology, Boston Children's Hospital, Boston, MA.
³ Division of Pediatric Critical Care, Department of Pediatrics, Cooperman Barnabas Medical Center, Livingston, NJ.
⁴ Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO.
⁵ Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN.
⁶ Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, UT.
⁷ Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL.
⁸ Division of Critical Care, Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
⁹ Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, AR.
¹⁰ Division of Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA; Departments of Anaesthesia and Pediatrics, Harvard Medical School, Boston, MA.
¹¹ COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, GA.
¹² Division of Immunology, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, MA. Electronic address: marybeth.son@childrens.harvard.edu.

PMID: 36870559
DOI: 10.1016/j.jpeds.2023.01.025

Abstract

Aseptic meningitis is a rare but potentially serious complication of intravenous immunoglobulin treatment. In this case series, meningitic symptoms following intravenous immunoglobulin initiation in patients with multisystem inflammatory syndrome were rare (7/2,086 [0.3%]). However, they required the need for additional therapy and/or readmission.

Keywords: SARS-CoV-2; drug-induced aseptic meningitis; intravenous immunoglobulin; multisystem inflammatory syndrome in children (MIS-C).

Publication types

Case Reports
Research Support, N.I.H., Extramural

MeSH terms

Administration, Intravenous
Child
Disease Progression
Humans
Immunoglobulins, Intravenous* / therapeutic use
Meningitis, Aseptic* / diagnosis
Meningitis, Aseptic* / drug therapy

Substances

Immunoglobulins, Intravenous

Supplementary concepts

pediatric multisystem inflammatory disease, COVID-19 related

Grants and funding

K23 DK119463/DK/NIDDK NIH HHS/United States