TITLE:
Prevention of Refractory Headache Secondary to Immunoglobulins Using Diuretics: A Case Report
AUTHORS:
Elisa Rodado Alabau, Natàlia Gabarró Llatge, Gisela Martín Ozaeta, Alejandro Moya Valdés
KEYWORDS:
Intravenous Immunoglobulin, Headache, Diuretics, Immune-Mediated Necrotizing Myopathy, Adverse Effects, Case Report
JOURNAL NAME:
Open Journal of Rheumatology and Autoimmune Diseases,
Vol.16 No.2,
March
19,
2026
ABSTRACT: Immunoglobulins (IG) are essential in the treatment of autoimmune diseases, although their adverse effects may force treatment withdrawal. We describe the case of a patient with immune‑mediated necrotizing myopathy (IMNM) who developed severe refractory headache after IG infusions. Based on the reproducible chronology of symptoms and clinical signs of hypervolemia, a preventive strategy using loop diuretics was implemented. Oral furosemide administered during the risk period prevented the onset of IG‑related headache in subsequent cycles, with excellent clinical response. This case highlights the importance of addressing IG‑related adverse effects and suggests that short courses of diuretics may be considered in selected patients with reproducible headache patterns.