Treatment of Childhood Idiopathic Thrombocytopenic Purpura with Anti-D (WinRho(R)).
- Author:
Hwa Young PARK
1
;
Chang Gyu KANG
;
Mi Yong SHIN
;
Kang Mo AHN
;
Ki Woong SUNG
;
Hong Hoe KOO
Author Information
1. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Idiopathic thrombocytopenic purpura;
Anti-D
- MeSH:
Anemia, Hemolytic;
Bilirubin;
Blood Platelets;
Child;
Diagnosis;
Haptoglobins;
Hemorrhage;
Hemostasis;
Humans;
Immunoglobulins;
Platelet Count;
Purpura, Thrombocytopenic, Idiopathic*;
Reticulocytes;
Splenectomy;
Thrombocytopenia
- From:Korean Journal of Pediatric Hematology-Oncology
2000;7(2):187-193
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Anti-D immunoglobulin has recently emerged as a theraputic option for the treatment of patients with idiopathic thrombocytopenic purpura (ITP). There is no report about anti-D treatment in our country. In this report, the efficacy and adverse reactions of anti-D immunoglobulin in children with ITP were evaluated. METHPDS: From August, 1997 to September, 1998, 7 courses of anti-D treatment were applied in 4 children who had persisting thrombocytopenia and frequent bleeding episodes despite use of intravenous immunoglobulin and corticosteroid. They were Rh-positive and non-splenectomized patients. They received 43~60 mug/kg/dose of anti-D (WinRho ) twice with 7 days interval at out patient department. To evaluate the efficacy and adverse reactions of anti-D, platelet, reticulocyte, hemoglobin, bilirubin and haptoglobin counts were observed weekly. RESULTS: Median age and pretreatment duration after diagnosis were 22 months (15~77 months) and 7 months (2~46 months), respectively. Bleeding decreased significantly after anti-D treatment. Platelet count increased median 4.11 folds (1.85~13.67 folds) and response was maximal at day 7. Duration of platelet increase more than 2 folds was 5 weeks (0~10 weeks). No significant adverse reactions other than mild hemolytic anemia was present. Hemoglobin decreased to minimal 88% (79.5~95.9%) of pretreatment value. Duration of hemoglobin lower than 90% of pretreatment value was 1 week (0~4 weeks). After 10 weeks, platelet and hemoglobin returned to pretreatment value. CONCLUSION: Although anti-D is not a curative treatment for ITP, it is safe and repeated infusions of anti-D can be used to maintain the platelet count at a level of sufficient to provide adequate hemostasis and may enable children to postpone or even avoid splenectomy.
