Korean J Hematol.  2001 Aug;36(3):241-246.

Low-dose and Short-term Therapy of Intravenous Immunoglobulin G for Childhood Acute Immune Thrombocytopenic Purpura (1)

• Lee SM
• Lee DH
• Lee KS

Abstract

BACKGROUND
To reduce life-threatening complication of childhood acute immune thrombocytopenic purpura (ITP), high-dose intravenous immnuoglobulin G (IVIG) therapy has been used since 1981 by Imbach, et al. Several methods of dose and duration of IVIG therapy have been developed. But total doses were 2 g/kg in most of them. To reduce the total doses, we tried to use IVIG according to the patient's response. This study was conducted to evaluate the effect of low-dose and short-term immunoglobulin therapy for childhood acute ITP according to individual clinical course.
METHODS
This study was conducted in 73 childhood acute ITP who was diagnosed at the Department of Pediatrics, Kyungpook National University Hospital from September, 1983 to August, 1993. Until June, 1985, IVIG (400mg/kg/day) was given for 5 days in 9 children regardless of the increment of platelet count, but after then IVIG was not given basically when the platelet count was increased above 100,000/mm3. The time to reach targeted platelet count and the rate of relapse and conversion to chronic ITP were evaluated.
RESULTS
The mean age was 5.5 years and male to female ratio was 1.4 : 1 and the median duration of follow up was 2.1 years. Among 47 cases who were followed up over 6 months, 13 cases (17.7%) were chronic. The mean days of IVIG therapy was 2.3 days. the mean platelet count was 15,770+/-13,730/mm3 at diagnosis. The paltelet count began to rise above 50,000/mm3 at 2.3 days, 100,000/mm3 at 2.8 days and 150,000/mm3 at 3.5 days of IVIG therapy. But the platelet count was not increased above 100,000/mm3 in 11 cases among those who were given over 4 days or more IVIG therapy. The relapse and the chronic ITP was less developed in rapid responders at the level of 50,000/mm3 than in slow responders (P<0.05).
CONCLUSION
The short-term (less than 4 days) IVIG therapy is desirable for effect and cost in childhood acute ITP.

Keyword

Immune thrombocytopenic purpura; Childhood; Intravenous immnuoglobulin G; Low-dose; Short-term

MeSH Terms

Child
Diagnosis
Female
Follow-Up Studies
Gyeongsangbuk-do
Humans
Immunization, Passive
Immunoglobulin G*
Immunoglobulins*
Immunoglobulins, Intravenous
Male
Pediatrics
Platelet Count
Purpura, Thrombocytopenic, Idiopathic*
Recurrence
Immunoglobulin G
Immunoglobulins
Immunoglobulins, Intravenous