Anti-RH immunoglobulin therapy for human immunodeficiency virus-related immune thrombocytopenic purpura.
The potential hazards of steroids in human immunodeficiency virus (HIV)-infected patients led us to evaluate the effectiveness and safety of anti-D and anti-c Ig in 17 adults with severe HIV-related immune thrombocytopenic purpura (platelet count less than 20 x 10(9)/L). The 14 Rh+ patients received 12 to 25 micrograms/kg of anti-D IgG intravenously on two consecutive days. A significant platelet rise above 50 x 10(9)/L was obtained in nine patients. Repeated boosters were performed in six cases and were effective in all cases. The 3 Rh- patients had a good response after they were given 20 mL x 2 of plasma containing potent anti-c antibodies. Therapy was well tolerated, and only one patient had significant hemolysis. These data suggest that anti-Rh IgG can be effective and safe in HIV-related thrombocytopenic purpura and that a specific interaction between the RBC antigens and the anti-Rh antibodies is required.
Oksenhendler
E
E
Department of Immunohematology, Institut National de la Santé et de la Récherche Medicale U108, Paris, France.
Bierling
P
P
Brossard
Y
Y
Schenmetzler
C
C
Girard
P M
PM
Seligmann
M
M
Clauvel
J P
JP
D001327:Autoimmune Diseases / Q000209:etiology / Q000628:therapy*; D005069:Evaluation Studies as Topic; D005260:Female; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D007116:Immunization, Passive; D007518:Isoantibodies / Q000627:therapeutic use*; D008297:Male; D011696:Purpura, Thrombocytopenic / Q000209:etiology / Q000628:therapy*; D012204:Rh-Hr Blood-Group System / Q000276:immunology*; D018029:Rho(D) Immune Globulin
D007518:Isoantibodies; D012204:Rh-Hr Blood-Group System; D018029:Rho(D) Immune Globulin