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Intravenous immune globulin versus intravenous anti-D immune globulin for the treatment of acute immune thrombocytopenic purpura

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Abstract

Objective

The purpose of this study was to compare the efficacy and side effects of intravenous immunoglobulin (IVIG) with intravenous anti-D immunoglobulin for treatment of newly diagnosed acute childhood Idiopathic thrombocytopenic purpura (ITP).

Methods

Children (6 months to 14 years) with newly diagnosed acute ITP and platelet count below 20,000/ μL were randomized to receive single dose intravenous 75 μg/kg anti-D or 1g/kg IVIG for two consecutive days (total dose 2 g/kg). Response rate defined as a platelet count over 20,000 / μL 72 hours after initial treatment.

Results

Eighty one patients (52 male and 29 female) with mean age of 5 years and 3 months randomly divided in anti-D group (n=42) and IVIG group (n=39). Mean baseline (pretreatment) platelet counts were 15406 / μL and 15230/ μL in anti-D and IVIG group, respectively. The response rate in IVIG group (98%) was more significant than anti-D group (76%); (P = 0.017). After 7 days the platelet counts of all patients in IVIG group were more than 20,000/ μL while in anti-D group 12% had platelet counts below 20,000/ μL.

Conclusion

In acute childhood ITP, initial treatment with IVIG (2g/Kg in divided dose) increased platelet count more rapidly and more significant than intravenous anti-D (single dose of 75 μg/Kg) within the first 72 hours.

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Authors and Affiliations

  1. Division of Hematology/Oncology, Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran

    Elham Shahgholi & Mohammad Ali Ehsani

  2. Division of Hematology/Oncology, Department of Pediatrics, Iran University of Medical Sciences, Tehran, Iran

    Parvaneh Vosough, Khadijeh Arjomandi & Shahla Ansari

  3. Research and Development Center, Tehran University of Medical Sciences, Tehran, Iran

    Kambiz Sotoudeh

  4. Department of Pediatrics, Iran University of Medical Sciences, Tehran, Iran

    Soraya Salehi

  5. Division of Hematology/Oncology, Department of Pediatrics, Semnan University of Medical Sciences, Semnan, Iran

    Mohammad Faranoush

  6. Department of Pediatric Hematology/Oncology, Bahrami Children’s Hospital, Shaheed Kiaee St, Damavand Ave., Tehran, 16417, Iran

    Elham Shahgholi

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  1. Elham Shahgholi
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  2. Parvaneh Vosough
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  3. Kambiz Sotoudeh
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  4. Khadijeh Arjomandi
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  5. Shahla Ansari
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  6. Soraya Salehi
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  7. Mohammad Faranoush
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  8. Mohammad Ali Ehsani
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Correspondence to Elham Shahgholi.

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Shahgholi, E., Vosough, P., Sotoudeh, K. et al. Intravenous immune globulin versus intravenous anti-D immune globulin for the treatment of acute immune thrombocytopenic purpura. Indian J Pediatr 75, 1231–1235 (2008). https://doi.org/10.1007/s12098-008-0243-y

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  • DOI: https://doi.org/10.1007/s12098-008-0243-y

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