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

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.