Intravenous gamma-globulin (Sandoglobulin) therapy in the management of four patients with immune thrombocytopenic purpura.
We have used intravenous polyvalent intact gamma-globulin concentrate (Sandoglobulin-immune globulin IV) in the management of 2 adults and 2 children with refractory immune thrombocytopenic purpura (ITP). Excellent responses were obtained in 2 children with chronic ITP as compared to no response in 2 adults with long-standing, severe ITP. The 2 adults who failed intravenous Sandoglobulin therapy had prolonged reticuloendothelial system (RES) clearance of autologous antibody-coated red blood cells before initiation of therapy as compared to normal RES clearance rates in the 2 children who responded to therapy. Blockade of the RES is one mechanism by which intravenous Sandoglobulin therapy may reverse thrombocytopenia in ITP - our observations suggest that patients who have impaired RES function before starting intravenous Sandoglobulin therapy may fail to respond to treatment. Continued studies are required to confirm these observations.
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D000293:Adolescent; D000368:Aged; D001792:Blood Platelets / Q000276:immunology; D002675:Child, Preschool; D006801:Humans; D007116:Immunization, Passive; D005779:Immunodiffusion; D007074:Immunoglobulin G / Q000032:analysis; D007263:Infusions, Parenteral; D008875:Middle Aged; D012157:Mononuclear Phagocyte System / Q000276:immunology; D013921:Thrombocytopenia / Q000276:immunology / Q000628:therapy*; D005719:gamma-Globulins / Q000008:administration & dosage*
D007074:Immunoglobulin G; D005719:gamma-Globulins