title: Anti-D immunoglobulin treatment for thrombocytopenia associated with primary antibody deficiency.
abstract: 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.
authors.affiliation: Department of Immunopathology, Barts and The London NHS Trust, London EC1A 7BE, UK. hlonghurst@doctors.org.uk
authors.forename: H J
authors.initials: HJ
authors.lastname: Longhurst
authors.forename: C
authors.initials: C
authors.lastname: O'Grady
authors.forename: G
authors.initials: G
authors.lastname: Evans
authors.forename: C
authors.initials: C
authors.lastname: De Lord
authors.forename: A
authors.initials: A
authors.lastname: Hughes
authors.forename: J
authors.initials: J
authors.lastname: Cavenagh
authors.forename: M R
authors.initials: MR
authors.lastname: Helbert
mesh_terms: 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*
chemical_list: D018029:Rho(D) Immune Globulin