High-dose intravenous therapy with immune globulin before delivery for idiopathic thrombocytopenic purpura.
A 15-year-old girl with a 9-year history of idiopathic thrombocytopenic purpura resistant to high-dose steroid therapy and to splenectomy was admitted to hospital at 35 weeks' gestation with a platelet count of 10 X 10(9)/L. The bleeding time was normal, and measures of platelet aggregation were nearly so. Treatment with high intravenous doses of polyvalent immune globulin led to a rise in the platelet count to more than 110 X 10(9)/L within 5 days. An elective cesarean section was performed through the lower uterine segment with good hemostasis. After delivery the platelet count fell to its former level, but no postpartum bleeding occurred. There was a brief episode of thrombocytopenia in the infant, with some petechiae but no other hemorrhagic manifestations. No untoward effects of the immune globulin infusion were observed in either mother or daughter.
D000293:Adolescent; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage / Q000031:analogs & derivatives*; D016756:Immunoglobulins, Intravenous; D007231:Infant, Newborn; D007263:Infusions, Parenteral; D010976:Platelet Count; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood / Q000628:therapy*; D011300:Preoperative Care; D011696:Purpura, Thrombocytopenic / Q000097:blood / Q000628:therapy*
D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous