Guillain-Barré syndrome complicated by myocarditis and acute kidney injury after maltose-based IVIG treatment: A case report
Anjusha K. Johnson, Joby Thomas Mammen, Mary Priya, Dharini BhoopathiBackground
Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP), the most common form of Guillain-Barré Syndrome (GBS), may rarely be complicated by myocarditis, which results from an inflammatory or autoimmune response. Conversely, acute kidney injury (AKI), caused by osmotic nephrosis, is an uncommon adverse effect associated with maltose-based intravenous immunoglobulin (IVIG) therapy, a common treatment for GBS.
Case presentation
A 41-year-old diabetic male diagnosed with AIDP received maltose-based IVIG. After 75 g administration, he developed flu-like symptoms and AKI, followed by signs of myocarditis, including elevated troponin, reduced ejection fraction, and ECG changes. IVIG was discontinued early due to these adverse effects. The patient required ICU care and hemofiltration but recovered with supportive treatment.
Conclusion
This case highlights myocarditis as a rare complication of GBS and demonstrates that IVIG, while essential in treatment, even though maltose based, can lead to serious adverse effects including AKI, particularly in high-risk patients.