Non-ST Elevation Myocardial Infarction After High-dose Intravenous Immunoglobulin in a Patient with Systemic Lupus Erythematosus

Intravenous immunoglobulin is frequently used in the treatment of autoimmune and hematologic disorders. While generally well tolerated, intravenous immunoglobulin administration can rarely precipitate serious cardiovascular events, including acute coronary syndrome, particularly in patients with preexisting atherosclerotic disease. We report the case of a 61-year-old woman with systemic lupus erythematosus, prior coronary artery disease, and immune thrombocytopenic purpura who developed non-ST elevation myocardial infarction following high-dose intravenous immunoglobulin therapy. Coronary angiography revealed critical stenoses in the left anterior descending and left circumflex arteries, and successful percutaneous coronary intervention was performed. This case highlights the importance of careful cardiovascular assessment prior to intravenous immunoglobulin initiation in high-risk individuals and the need for monitoring for ischemic symptoms during infusion in susceptible populations.