[Treatment of autoimmune neonatal thrombocytopenia with high-dose intravenous immunoglobulins].
During the neonatal period, 6 infants born to mothers with auto-immune thrombocytopenia purpura were diagnosed as having severe thrombopenia (platelet counts below 30 X 10(9)/l). High doses of intravenous immunoglobulins (IVIG) (0.4 g/kg/injection for 2 infants and 1 g/kg/injection for 4 infants) were administered as of the first week of life. Short-term efficacy was good in all cases (platelet counts over 50 X 10(9)/l, 2-10 days after the first injection). During the second week of life, 5 newborns had relapses which were rapidly reversed by one or several IVIG injections. The thrombopenia was cured between days 19 (shortest) and 41 (longest) and, more over, no side effects were observed. High doses of IVIG seem to be an effective and well-tolerated treatment for neonatal auto-immune thrombopenia, and they can be recommended over classical treatments (corticotherapy, exchange transfusion, platelet transfusion) as a first line of attack.
Service de Médecine Interne-Hématologie, Hôpital Sud, CHU de Rennes.
B
B
Grosbois
E
E
Le Gall
J C
JC
Picaud
P
P
Poulain
C
C
Bergeron
D
D
Jacomy
J Y
JY
Grall
R
R
Leblay
D000328:Adult; D001327:Autoimmune Diseases / Q000151:congenital / Q000628:therapy*; D005260:Female; D006801:Humans; D007116:Immunization, Passive; D007231:Infant, Newborn; D007275:Injections, Intravenous; D010976:Platelet Count; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000276:immunology; D012008:Recurrence; D013921:Thrombocytopenia / Q000151:congenital / Q000628:therapy*
Traitement de la thrombopénie néonatale auto-immune par les immunoglobulines intraveineuses à fortes doses.