Anti-D immunoglobulin treatment for thrombocytopenia associated with primary antibody deficiency.
OBJECTIVE
To review our experience of anti-D immunoglobulin for immune thrombocytopenia (ITP) in patients with primary antibody deficiency.


METHODS
A retrospective case notes review of four Rhesus positive patients with ITP and primary antibody deficiency, treated with anti-D. Patients were refractory to steroids and high dose intravenous immunoglobulin (IVIG). Two patients were previously splenectomised.


RESULTS
All patients responded to anti-D immunoglobulin. Improved platelet counts were sustained for at least three months. Side effects included a fall in haemoglobin in all cases; one patient required red blood cell transfusion. Two patients had transient neutropenia (< 1 x 10(9)/litre).


CONCLUSIONS
Anti-D immunoglobulin may be an effective treatment for antibody deficiency associated thrombocytopenia, even after splenectomy. Anti-D immunoglobulin may have considerable clinical advantages in this group of patients, where treatments resulting in further immunosuppression are relatively contraindicated.
Longhurst
H J
HJ
Department of Immunopathology, Barts and The London NHS Trust, London EC1A 7BE, UK. hlonghurst@doctors.org.uk
O'Grady
C
C
Evans
G
G
De Lord
C
C
Hughes
A
A
Cavenagh
J
J
Helbert
M R
MR
D000328:Adult; D017074:Common Variable Immunodeficiency / Q000150:complications; D005260:Female; D006801:Humans; D017098:IgA Deficiency / Q000150:complications; D008875:Middle Aged; D010976:Platelet Count; D012189:Retrospective Studies; D018029:Rho(D) Immune Globulin / Q000627:therapeutic use*; D013921:Thrombocytopenia / Q000209:etiology / Q000276:immunology / Q000628:therapy*
D018029:Rho(D) Immune Globulin