Steroid-free interval with anti-D in chronic idiopathic thrombocytopenic purpura

Acta Paediatr Jpn. 1993 Feb;35(1):36-8. doi: 10.1111/j.1442-200x.1993.tb03002.x.

Abstract

Chronic idiopathic thrombocytopenic purpura (ITP) is an autoimmune disease characterized by the antibody-mediated destruction of platelets. To maintain the platelets above the symptomatic level we administered 100 micrograms of anti-D for 5 consecutive days to 19 children with ITP. Four patients did not respond to the treatment. Fifteen responded with an increase in the average platelet number to 76,000/microL 7 days postinjection. However, the platelet count dropped within 45 days to 27,000/microL. Three months after this study, two patients from the study group were then administered monthly anti-D after reinjecting anti-D daily for 5 consecutive days, as previously performed. Platelet levels in these two patients were maintained above 30,000/microL for 5 and 6 months respectively. We concluded that anti-D administration for 5 consecutive days can induce an increase in platelets followed by a decrease below 30,000/microL after 30-45 days. However, monthly administration of anti-D after daily injections for 5 consecutive days can keep platelets above the symptomatic level and may provide a corticosteroid-free safe interval for nearly 5 months.

MeSH terms

  • Adolescent
  • Child
  • Chronic Disease
  • Drug Administration Schedule
  • Female
  • Humans
  • Immunoglobulins / administration & dosage*
  • Immunoglobulins, Intravenous / administration & dosage*
  • Male
  • Platelet Count
  • Purpura, Thrombocytopenic, Idiopathic / blood
  • Purpura, Thrombocytopenic, Idiopathic / therapy*
  • Rho(D) Immune Globulin

Substances

  • Immunoglobulins
  • Immunoglobulins, Intravenous
  • Rho(D) Immune Globulin