Anti-D immunoglobulin-induced prolonged intravascular hemolysis and neutropenia.

Abstract

Intravenous anti-D immunoglobulin (anti-D IVIG) is indicated for the treatment of immune thrombocytopenic purpura (ITP) in nonsplenectomized patients who are Rh(D)-positive. Recent reports have described episodes of intravascular hemolysis after anti-D IVIG. We report an adolescent boy with chronic ITP who required multiple transfusions of erythrocyte suspensions when intravascular hemolysis persisted for 6 months after anti-D IVIG treatment. He did not have hemolytic anemia before treatment. The features of our case suggest that pediatric patients treated with anti-D IVIG for ITP should be closely monitored for signs and symptoms of hemoglobinemia and/or hemoglobinuria, and clinically significant anemia. Our case proposes that persistence of immune hemolysis after this treatment may be related to presence of previously defined predisposing agents like tuberculosis and antituberculous therapy. Our observations suggest that steroid therapy can be effective in patients who developed prolonged hemolytic anemia and neutropenia after anti-D IVIG therapy.

• Authors: Bulent Alioglu, Zekai Avci, Emel Ozyurek, Namik Ozbek
• Journal: Journal of pediatric hematology/oncology (J Pediatr Hematol Oncol) Vol. 29 Issue 9 Pg. 636-9 (Sep 2007) ISSN: 1077-4114 [Print] United States
• PMID: 17805040 (Publication Type: Case Reports, Journal Article)

Chemical References

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

Topics

• Adolescent
• Anemia, Hemolytic (diagnosis, drug therapy, etiology)
• Hemoglobins (analysis)
• Hemolysis
• Humans
• Immunoglobulins, Intravenous (adverse effects, therapeutic use)
• Male
• Neutropenia (diagnosis, drug therapy, etiology)
• Purpura, Thrombocytopenic, Idiopathic
• Rho(D) Immune Globulin (adverse effects, therapeutic use)