Clin Pediatr Hematol Oncol.  2013 Apr;20(1):22-28.

An Analysis of Neutropenia after the Administration of High-dose Intravenous Immunoglobulin or Anti-D Immunoglobulin on Acute Immune Thrombocytopenic Purpura Children: Age based Analysis

• Chae MH
• Park SW
• Jeon IS

Abstract

BACKGROUND
The purpose of this study is to evaluate the decreased neutrophil count after the administration of high-dose intravenous immunoglobulin (IVIG) or anti-D immunoglobulin (anti-D Ig) to children with acute immune thrombocytopenic purpura (ITP). In addition, post-treatment changes in absolute neutrophil count (ANC) were also analyzed according to patient age.
METHODS
We retrospectively performed a chart review of 83 patients who had received IVIG or anti-D Ig to manage the decreased platelet count due to acute ITP. Pre- and post-treatment ANC were analyzed in the IVIG treatment group and anti-D Ig treatment group, and ANC were compared between each group. In addition, all the subjects were divided into two groups according to age: infantile group and other group, and ANC of these two groups were compared.
RESULTS
A decrease in ANC in just a day and recovering to its pre-treatment value on the 7th post-treatment day was observed for the IVIG treatment group. Especially, the decrease in ANC observed in the infantile group was found to recover in 14 days, where-as ANC recovery in the other group was seen within 2 days after the treatment. There was no statistically significant decrease in ANC in the anti-D Ig treatment group.
CONCLUSION
IVIG used for childhood acute ITP caused a decrease in ANC more severely than with the administration of anti-D Ig. Subjects aged less than 12 months who were treated with IVIG for acute ITP showed more ANC decrease and needed longer time to recover normal ANC compared to those over 12 months of age.

Keyword

Intravenous immunoglobulin; Anti-D immunoglobulin; Immune thrombocytopenic purpura; Absolute neutrophil count

MeSH Terms

Aged
Child
Humans
Immunoglobulins
Immunoglobulins, Intravenous
Isoantibodies
Neutropenia
Neutrophils
Platelet Count
Purpura, Thrombocytopenic, Idiopathic
Retrospective Studies
Immunoglobulins
Immunoglobulins, Intravenous
Isoantibodies