Korean J Hematol.  2001 Aug;36(3):247-252.

Low-dose and Short-term Therapy of Intravenous Immunoglobulin G for Childhood Acute Immune Thrombocytopenic Purpura (2)

• Lee KS

Abstract

BACKGROUND
We reported the results of low-dose and short-term intravenous immnuoglobulin G (IVIG) therapy to raise the platelet count over 100,000/mm3 for childhood acute idiopathic thrombocytopenic purpura (ITP) according to the individual clinical response. The effects had no differences in two groups between low-dose and full-dose. This study was conducted to compare the recurrence rate and chronicity in patients who were given IVIG according to the individual clinical course until the platelet counts over 50,000/mm3.
METHODS
The low-dose and short-term IVIG therapy (400mg/kg/day) until rising the platelet counts over 50,000/mm3 was attempted in 68 childhood ITP who were diagnosed at the Department of Pediatrics, Kyungpook National University Hospital from September, 1993 to April, 2001. The patients rising the platelet counts over 50,000/mm3 after 1~2, 3~4, and 5 or more doses of IVIG were defined a rapid, intermediate and slow responder (RR, IR, and SR).
RESULTS
The median age was 3.2 years and male to female ratio was 2.6:1 and the median duration of follow up was 2.1 years. Among 47 cases who were followed up over 6 months, 14 cases (29.8%) were into chronic ITP. The days of IVIG therapy was one in 10, two in 19, three in 17, four in 7, five in 5, six in 3, seven in 1, eight in 3, nine in 1, twelve in 1 and fourteen in one children. The median platelet counts was 16,180+/-10,309/mm3 at diagnosis and was increased to 36,164+/-27,570/mm3 after 1 day, 76,076+/-56,463/mm3 after 2 days, 107,470+/-68,236/mm3 after 3 days, 95,814+/-52,473/mm3 after 4 days and 109,850+/-56,785/mm3 after 5 days of IVIG therapy. But the platelet count was not increased above 100,000/mm3 in 7 cases among those who were given over 4 days or more IVIG therapy. The platelet counts began to rise above 50,000/mm3 at 2.9 days, 100,000/mm3 at 4.0 days and 150,000/mm3 at 4.6 days of IVIG therapy. Four of 29 RR, 5 of 24 IR and 7 of 15 SR were relapsed (P value of RR vs SR=0.028). Seven of 28 RR, 1 of 11 IR and 6 of 8 SR became a chronic type (P value of RR vs SR=0.016, IR vs SR=0.006).
CONCLUSION
The low-dose and short-term IVIG according to the individual clinical response may be a desirable method for the treatment of 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
Immunoglobulin G*
Immunoglobulins*
Immunoglobulins, Intravenous
Male
Pediatrics
Platelet Count
Purpura, Thrombocytopenic, Idiopathic*
Recurrence
Immunoglobulin G
Immunoglobulins
Immunoglobulins, Intravenous