Intravenous immunoglobulin and anti-D in idiopathic thrombocytopenic purpura (ITP): mechanisms of action.
Infusion of large amounts of intravenous immunoglobulin (IVIG) or anti-D can reverse the low platelet count in patients with ITP within hours of the initiation of treatment. In some cases, the effects of IVIG appear to far outlast several half-lives of the product. Several mechanisms have been proposed to explain these rapid and long term effects and these will be discussed in this review.
Lazarus
A H
AH
Canadian Blood Services, Toronto Centre, ON, Canada.
Freedman
J
J
Semple
J W
JW
D000888:Antibodies, Anti-Idiotypic / Q000276:immunology; D001323:Autoantibodies / Q000276:immunology; D001327:Autoimmune Diseases / Q000276:immunology / Q000628:therapy*; D001792:Blood Platelets / Q000276:immunology; D002986:Clinical Trials as Topic; D006207:Half-Life; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D007075:Immunoglobulin M / Q000276:immunology; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007518:Isoantibodies / Q000627:therapeutic use; D008262:Macrophage Activation; D012157:Mononuclear Phagocyte System / Q000503:physiopathology; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000276:immunology / Q000628:therapy*; D018029:Rho(D) Immune Globulin
D000888:Antibodies, Anti-Idiotypic; D001323:Autoantibodies; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D016756:Immunoglobulins, Intravenous; D007518:Isoantibodies; C061961:RHO(D) antibody; D018029:Rho(D) Immune Globulin