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Single dose of anti-D immune globulin at 75 microg/kg is as effective as intravenous immune globulin at rapidly raising the platelet count in newly diagnosed immune thrombocytopenic purpura in children.

AbstractOBJECTIVE:
To conduct a randomized prospective trial of immune globulin treatment for 105 Rh+ children with newly-diagnosed immune thrombocytopenic purpura and a platelet count<20,000/microL, to determine whether anti-D immune globulin (anti-D) is as effective as intravenous immune globulin (IVIg).
STUDY DESIGN:
Eligible patients received either a single intravenous dose of 50 microg/kg anti-D (anti-D50), 75 microg/kg anti-D, (anti-D75), or 0.8 g/kg IVIg, (IVIg). Patients were monitored for response to treatment and adverse events.
RESULTS:
By 24 hours after treatment 50%, 72%, and 77% of patients in the anti-D50, anti-D75, and IVIg groups, respectively, had achieved a platelet count>20,000/microL (P=.03). By day 7, hemoglobin concentrations decreased by 1.6 g/dL, 2 g/dL, and 0.3 g/dL in the anti-D50, anti-D75, and IVIg groups, respectively. Headache, fever, or chills occurred least often in the anti-D50 group.
CONCLUSIONS:
A single 75 microg/kg dose of Anti-D raised the platelet count in children with newly diagnosed immune thrombocytopenic purpura more rapidly than standard-dose anti-D and as effectively as IVIg, with an acceptable safety profile.
AuthorsMichael D Tarantino, Guy Young, Salvatore J Bertolone, Karen A Kalinyak, Frank E Shafer, Roshni Kulkarni, Lisa C Weber, Mary L Davis, Henry Lynn, Diane J Nugent, Acute ITP Study Group
JournalThe Journal of pediatrics (J Pediatr) Vol. 148 Issue 4 Pg. 489-94 (Apr 2006) ISSN: 0022-3476 [Print] United States
PMID16647411 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Immunoglobulins, Intravenous
  • Immunologic Factors
  • Rho(D) Immune Globulin
Topics
  • Adolescent
  • Child
  • Child, Preschool
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Immunoglobulins, Intravenous (therapeutic use)
  • Immunologic Factors (administration & dosage, adverse effects, pharmacology)
  • Infant
  • Male
  • Platelet Count
  • Prospective Studies
  • Purpura, Thrombocytopenic, Idiopathic (blood, drug therapy)
  • Rho(D) Immune Globulin (administration & dosage, adverse effects, pharmacology)

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