Comparison of the efficacy of a two-day and a five-day schedule for infusing intravenous gamma globulin in the treatment of immune thrombocytopenic purpura in adults.
The standard schedule for treating immune thrombocytopenia purpura in adults with intravenous immunoglobulin G infusion (IVIG), 400 mg/kg per day for five days, was compared with a shorter schedule using 1,000 mg/kg per day for two days. Both schedules were found to be effective in correcting thrombocytopenia. Eleven of the 17 patients treated with the five-day regimen and nine of 10 patients treated with the two-day regimen had significant responses. Patients with an initial platelet count of less than 20,000 platelets/mm3 or with an estimated in vivo platelet survival in excess of 90 hours were less likely to have a response than were other patients. There were no serious side effects in either group, but thrombophlebitis was observed in some patients receiving the five-day regimen when a single intravenous catheter was used for more than three days. Headaches and, less commonly, low-grade fever were noted in some patients receiving the two-day regimen when infusions were given at flow rates in excess of 0.04 ml/kg/minute. Since the two-day regimen requires shorter hospitalization and corrects thrombocytopenia slightly faster than the five-day course, it may be particularly useful in correcting thrombocytopenia in hospitalized patients requiring splenectomy or other surgery.
D000328:Adult; D000368:Aged; D001327:Autoimmune Diseases / Q000628:therapy*; D001792:Blood Platelets / Q000502:physiology; D002470:Cell Survival; D004334:Drug Administration Schedule; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage / Q000627:therapeutic use*; D016756:Immunoglobulins, Intravenous; D007275:Injections, Intravenous; D008875:Middle Aged; D010976:Platelet Count; D011696:Purpura, Thrombocytopenic / Q000628:therapy*; D013924:Thrombophlebitis / Q000209:etiology
D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous