|
Intravenous immune globulin versus intravenous
anti-D immune globulin for the treatment of acute immune
thrombocytopenic purpura.
Indian J Pediatr. 2008 Dec;75(12):1231-5. Epub 2009 Feb 4.
Shahgholi E, Vosough P, Sotoudeh K, Arjomandi K, Ansari S, Salehi S, Faranoush M, Ehsani MA.
Division
of Hematology/Oncology, Department of Pediatrics, Tehran University of
Medical Sciences, Tehran, Iran.
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
OBJECTIVE:
The purpose of this study was to compare the efficacy and side effects
of intravenous immunoglobulin (IVIG) with intravenous anti-D
immunoglobulin for treatment of newly diagnosed acute childhood
Idiopathic thrombocytopenic purpura (ITP). METHODS: Children (6 months
to 14 years) with newly diagnosed acute ITP and platelet count below
20,000/ microL were randomized to receive single dose intravenous 75
microg/kg anti-D or 1g/kg IVIG for two consecutive days (total dose 2
g/kg). Response rate defined as a platelet count over 20,000 / microL
72 hours after initial treatment. RESULTS: Eighty one patients (52 male
and 29 female) with mean age of 5 years and 3 months randomly divided
in anti-D group (n=42) and IVIG group (n=39).
Mean baseline
(pretreatment) platelet counts were 15406 / microL and 15230/ microL in
anti-D and IVIG group, respectively. The response rate in IVIG group
(98%) was more significant than anti-D group (76%); (P = 0.017). After
7 days the platelet counts of all patients in IVIG group were more than
20,000/ microL while in anti-D group 12% had platelet counts below
20,000/ microL. CONCLUSION: In acute childhood ITP, initial treatment
with IVIG (2g/Kg in divided dose) increased platelet count more rapidly
and more significant than intravenous anti-D (single dose of 75
microg/kg) within the first 72 hours.
|
