Deep venous thrombosis after high-dose intravenous immunoglobulin in the treatment of pemphigus vulgaris

A 43-year-old black man with pemphigus vulgaris was started on intravenous immunoglobulin (IVIg) therapy after his disease was found to be refractory to prednisone alone and prednisone in combination with mycophenolate mofetil, azathioprine, methotrexate, cyclosporine, and oral cyclophosphamide. The patient subsequently developed a deep venous thrombosis (DVT) that was attributed to the IVIg. IVIg has been associated with numerous thrombotic complications such as pulmonary embolism and myocardial infarction. Traditional risk factors for thrombotic complications, such as hypertension, a history of coronary artery disease, and immobility, should be considered as relative contraindications to IVIg therapy.