Acute Ischemic Stroke related to Intravenous Immunoglobulin

A 26-year-old man with a history of Philadelphia chromosome (Ph)-negative B-cell precursor (BCP) acute lymphoblastic leukemia (ALL) and prior chemotherapy and stem cell transplant was admitted due to thrombocytopenia and diffused interstitial bone marrow infiltration by atypical immature mononuclear cell. After being treated with chemotherapy, the patient developed prolonged fever despite getting antibiotics. Bronchoscope was done and human metapneumovirus pneumonia due to hypogammaglobulinemia was diagnosed. Three days after the 5 days course of IVIg, the patient developed sudden deterioration of consciousness and right hemiparesis. Imaging studies showed large left internal carotid artery (ICA) territory infarction. He died 4 days after the onset of stroke.