Intravenous immunoglobulin (IVIG) is a safe treatment to treat various neurological disorders, but fatal thrombotic events as rare complications have been reported. A 54-year-old woman with Guillain-Barre syndrome complained of dyspnea during IVIG treatment. She was finally diagnosed with pulmonary thromboembolism. To the best of our knowledge, this is the first case of pulmonary thromboembolism associated with IVIG treatment in a Korean patient with Guillain-Barre syndrome.

Background
Intravenous immunoglobulin (IVIg) has been administered for various immune-mediated neurological diseases such as autoimmune neuropathy, inflammatory myopathies, and other autoimmune neuromuscular disorders. The purpose of this study is to investigate side effects and complications of IVIg therapy in neuromuscular disorders.
Methods
We enrolled 29 patients (age 8~63 years) with IVIg therapy for various neurological diseases including Guillain-Barre syndrome, myasthenia gravis, dermatomyositis, polymyositis, chronic inflammatory demyelinating polyneuropathy, and multifocal motor neuropathy. IVIg therapy was used at a dose of 0.4 g/kg body weight/day for 5 consecutive days.
Results
10 patients (34%) had adverse events. There are adverse events in 16 courses (11%) among total 145 courses. The majority of patients presented with mild side effects, mostly asymptomatic laboratory changes. Rash or mild headache occurred in 3 patients. One patient showed a serious side effect of deep vein thrombosis.
Conclusions
IVIg therapy is safe for a variety of immune-mediated neurological diseases in our study.

Background
There were several studies comparing prognostic factors in Guillain-Barre syndrome treated with intravenousimmunoglobulin and plasmapheresis. However, there were controversies in what were significant factors andthere were few studies so far comparing the therapeutic outcomes in patients treated with immunoglobulin. This studywas aimed to determine the prognostic factors which affected the therapeutic outcome of Guillain-Barre syndrome treatedwith intravenous immunoglobulin.Method: We retrospectively reviewed the medical records of patients with Guillain-Barre syndrome admitted to ourhospital between January 1999 and March 2004. All patients were treated with intravenous immunoglobulin. Outcomeand prognosis were followed up after four weeks using the overall disability sum score.Results: Thirty-six patients were enrolled in this study. According to the clinical and electrophysiological findings,17 patients were AIDP, 10 were axonal forms, two were mixed and seven had electrophysiologically no evidence ofabnormalities. At a follow-up of four weeks, disabilities at the nadir (p<0.001) and admission (P<0.012), initial manifestationsof bulbar symptom (P<0.024) and electrodiagnostic features (P<0.013) were significantly correlated with outcomein patients treated with intravenous immunoglobulin. But only disabilities at the nadir (P<0.033) and electrodiagnosticfeatures (P<0.018) were significant in the multivariate logistic regression analysis.Conclusion: Among the patient treated with intravenous immunoglobulin, the outcomes were significantly differentaccording to the neurological status at the nadir. Therefore early diagnosis, administration of intravenous immunoglobulinand preventing complications during acute stages are essential to minimize neurological deficit and shorten the periodsof recovery.

Intravenous immunoglobulin (IVIg) is the treatment of choice for many autoimmune neuropathic disorders such as Guillain-Barre syndrome (GBS), chronic inflammatory Demyelinating neuropathy (CIDP), and multifocal motor neuropathy (MMN). IVIg is preferred because the adverse reactions are milder and fewer than the other immune-modulating methods such as steroid, other immunosuppressant such as azathioprine, and plasmapheresis. IVIg also has beenused in other autoimmune neuromuscular disorders (inflammatory myopathy, myasthenia gravis, and Lambert-Eaton myasthenic syndrome) and has been known as safe and efficient agent in these disorders. Since IVIg would get more indications and be used more commonly, clinicians need to know the detailed mechanism of action, side effects, and practical points of IVIg.