Syncope and New-Onset Bifascicular Block Associated With Intravenous Immunoglobulin in a Patient With Chronic Inflammatory Demyelinating Polyneuropathy

慢性炎症性脱髓鞘性多发性神经病患者静脉注射免疫球蛋白后出现晕厥和新发双束神经阻滞

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Abstract

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated neuropathy often treated with intravenous immunoglobulin (IVIG), which is generally well-tolerated but has occasionally been associated with rare cardiovascular side effects. We present the case of an 84-year-old male with CIDP, maintained on biweekly IVIG infusions, who experienced a syncopal episode with documented bradycardia of 30 beats per minute (bpm) during an infusion. Upon evaluation in the emergency department, the patient was found to have a new bifascicular block requiring pacemaker placement. This case underscores a rare adverse reaction associated with IVIG infusion, highlighting the importance of careful cardiac monitoring in older patients with CIDP and underlying or potential cardiac risk factors.

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