Korean J Blood Transfus.  2013 Dec;24(3):286-290.

Isolation of Anti-D after Administration of Intravenous Immune Globulin in a Patient with Immune Thrombocytopenic Purpura

• Chang J
• Kim HJ
• Yang HJ
• Kwon SW

Abstract

Intravenous immune globulin (IVIG) is widely used in treatment of hypogammablobulinemia and for immunomodulation. Passive transfer of anti-D activity through administration of IVIG may cause difficulty in serologic assessment of patients. Here we report on a case of passive anti-D from IVIG in a D positive patient. The patient was a 72-year-old Korean woman who was hospitalized for refractory immune thrombocytopenic purpura that is not cured after steroid therapy. IVIG 6,000 mg was administered for treatment of immune thrombocytopenic purpura. After IVIG administration for two days, we identified anti-D in the patient and a positive direct antiglobulin test was demonstrated. The patient's hemoglobin level remained unchanged. After IVIG administration for 10 days, the patient's specimen was negative for anti-D, as would be expected with passively acquired antibody. Antibodies in IVIG may confuse and complicate serologic testing of transfusion candidates. Therefore, passive transfer of anti-D should be considered when anti-D is detected, especially when the patient has received IVIG, as in this case.

Keyword

IVIG; Anti-D; Immune thrombocytopenic purpura

MeSH Terms

Aged
Antibodies
Coombs Test
Female
Humans
Immunoglobulins, Intravenous*
Immunomodulation
Purpura, Thrombocytopenic, Idiopathic*
Serologic Tests
Antibodies
Immunoglobulins, Intravenous