Neonatal autoimmune thrombocytopenia: role of high-dose intravenous immunoglobulin G therapy.
High-dose intravenous immunoglobulin G (IVIgG) therapy results in a rapid reversal of thrombocytopenia in over 80% of children with acute immune thrombocytopenic purpura (ITP). Comparable results were observed in eleven infants with an analogous condition, neonatal autoimmune thrombocytopenia (NATP), who received IVIgG (2 g/kg body weight) administered alone (n = 6) or in combination with steroids (n = 5). The median platelet count pre-IVIgG therapy was 25 X 10(9)/l (range 5 to 74 X 10(9)/l). The overall response rate to IVIgG therapy, administered alone or in combination with steroids was 75% (12 of 16 treatment episodes). A good response to therapy was defined as an increase in the platelet count to greater than or equal to 50 X 10(9)/l and at least twice the pre-treatment value at 48 h after completion of the IVIgG infusion. The rapid and generally excellent response to IVIgG therapy in infants with NATP suggests that this treatment approach should be considered as first-line therapy for severely thrombocytopenic infants with this self-limiting but potentially serious disorder.
Blanchette
V
V
Department of Pediatrics, Hospital For Sick Children, Toronto, Canada.
Andrew
M
M
Perlman
M
M
Ling
E
E
Ballin
A
A
D001327:Autoimmune Diseases / Q000628:therapy*; D005260:Female; D005315:Fetal Diseases / Q000628:therapy; D006801:Humans; D007116:Immunization, Passive; D007074:Immunoglobulin G / Q000008:administration & dosage; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000628:therapy*; D007275:Injections, Intravenous; D008297:Male; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000628:therapy; D011696:Purpura, Thrombocytopenic / Q000628:therapy*
D007074:Immunoglobulin G