Korean J Hematol.  2007 Sep;42(3):258-263. 10.5045/kjh.2007.42.3.258.

Therapeutic Efficacy of a Single Dose of Anti-D Immunoglobulin 50 microgram/kg in Childhood Acute Immune Thrombocytopenic Purpura

• Nam KL
• Cho SH
• Yang SW
• Son DW
• Jeon IS

• KMID: 2305201
• DOI: http://doi.org/10.5045/kjh.2007.42.3.258

Abstract

BACKGROUND: To investigate the efficacy and adverse effects of a single dose of anti-D immunoglobulin (50 microgram/kg) in Korean children with acute immune thrombocytopenic purpura (ITP).
METHODS
We serially evaluated the platelet count in 21 acute ITP patients that were treated with anti-D immunoglobulin (50 microgram/kg) to determine how many patients achieved platelet counts over the levels of 20 x 10(3)/mm3, 50 x 10(3)/mm3 and 100 x 10(3)/mm3 after the infusion of anti-D immunoglobulin. In addition, constitutional symptoms were monitored and changes in the hemoglobin levels were serially evaluated.
RESULTS
By three days after treatment, 90.5% of the patients had achieved a platelet count over 20 x 10(3)/mm3. At seven days after treatment, 66.7% of patients achieved a platelet count of 50 x 10(3)/mm3. In addition, at seven days after treatment 61.9% of patients achieved a platelet count of 100 x 10(3)/mm3. Constitutional adverse symptoms were observed 61.9% of patients, and the symptoms diminished spontaneously without any severe sequelaes. The decline of hemoglobin concentration after treatment recovered to the initial level after two weeks.
CONCLUSION
A single dose of anti-D immunoglobulin (50 microgram/kg)was effective in Korean children with acute ITP to raise the platelet count rapidly. The adverse effects of anti-D immunoglobulin, including hemolytic anemia, were not severe to prevent the use of the anti-D.

Keyword

Immune thrombocytopenic purpura (ITP); Anti-D; Hemolytic anemia

MeSH Terms

Anemia, Hemolytic
Child
Humans
Immunoglobulins*
Platelet Count
Purpura, Thrombocytopenic, Idiopathic*
Immunoglobulins

Figure

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  Fig. 1 Rate of platelet response over 20×103/mm3 per time in patients treated with anti-D. Values in whole bar (□ ■) and black portion (■) indicate the total subjects and the subjects who showed platelet count over 20× 103/mm3, respectively.

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  Fig. 2 Rate of platelet response over 50×103/mm3 per time in patients treated with anti-D. Values in whole bar (□ ■) and black portion (■) indicate the total subjects and the subjects who showed platelet count over 50× 103/mm3, respectively.

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  Fig. 3 Rate of platelet response over 100×103/mm3 per time in patients treated with anti-D. Values in whole bar (□■) and black portion (■) indicate the total subjects and the subjects who showed platelet count over 100× 103/mm3, respectively.

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  Fig. 4 The frequency of constitutional adverse symptoms by anti-D.

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  Fig. 5 Changes in hemoglobin values after anti-D infusion.

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