ABSTRACT
A 38-year-old man developed idiopathic thrombocytopenic purpura (ITP) 8 months following allogeneic BMT while being treated for cGVHD with corticosteroids and tacrolimus (FK506). He received two courses of high-dose intravenous immunoglobulin (IvIG) which resulted in transient improvement. A single dose of intravenous anti-D immunoglobulin induced a durable response. Anti-D immunoglobulin is better tolerated, less complicated to administer, and less expensive than a course of IvIG.
Subject(s)
Bone Marrow Transplantation/adverse effects , Purpura, Thrombocytopenic, Idiopathic , Rho(D) Immune Globulin/administration & dosage , Adult , Humans , Injections, Intravenous , Male , Purpura, Thrombocytopenic, Idiopathic/drug therapy , Purpura, Thrombocytopenic, Idiopathic/etiology , Transplantation, HomologousABSTRACT
The cost of irregular antibody screening in the third trimester exceeds +600,000.00 per perinatal death averted. This cost appears prohibitive compared with the clinical impact of the disease and costs of other screening tests.
Subject(s)
Antibodies/analysis , Prenatal Diagnosis/economics , Rh Isoimmunization/diagnosis , Costs and Cost Analysis , Female , Humans , Pregnancy , Pregnancy Trimester, ThirdABSTRACT
With the use of a murine monoclonal antibody with specificity for human blood group substance H, the distribution of this antigen on colorectal carcinomas and adenomatous polyps has been studied by immunohistochemistry. All of the 20 carcinomas studied were found to express H substance regardless of their location in the colon, their pathologic grade, or their clinical stage. Adenomas were variably positive for H substance, and expression of the antigen appeared to correlate with the degree of dysplasia seen on microscopic examination. Normal colonic mucosa, nonadenomatous polyps, and nonepithelial colonic neoplasms studied failed to express H substance. The results suggest that detection of H substance expression may be useful in the diagnosis of colonic malignancies and dysplastic premalignant lesions.
Subject(s)
Blood Group Antigens/immunology , Colonic Neoplasms/immunology , Rectal Neoplasms/immunology , Adenocarcinoma/immunology , Adenoma/immunology , Antibodies, Monoclonal/biosynthesis , Endothelium/immunology , Epitopes/immunology , Erythrocytes/immunology , Histocytochemistry , Humans , Immunoenzyme Techniques , Immunoglobulin M/biosynthesis , Intestinal Mucosa/immunology , Polyps/immunologyABSTRACT
Questions have been raised by statements of the American College of Obstetricians and Gynecologists that Rh immune globulin should be given to all Rh positive, Du variant, mothers who have recently delivered Rh positive infants. This practice is not recommended. However, blood banks must assure that a positive Du test on a mother's blood sample is not caused by a massive fetal-maternal hemorrhage. Failure to recognize this cause of a positive Du test may result in the administration of an inadequate dose of Rh immune globulin.
