After eight-year-tolerance minimal i.v. anti-D infusions unleash hemolysis in a patient with immune thrombocytopenic purpura (ITP).
Minimal doses of i.v. anti-D for ITP are not exempt from the risk of intravascular hemolysis, a rare potentially severe short-lived post-infusion complication. We report here on an elderly woman with chronic pancytopenia and splenomegaly in whom bleeding manifestations ceased after i.v. anti-Rh(D) immunoglobulin minidoses replaced long-term conventional treatment for immune thrombocytopenic purpura. Anti-Rh(D) infusions, that had been well tolerated for eight years, became the main culprit in triggering of disproportionate hemolysis. In spite of in crescendo complication, the anti-Rh(D) immunoglobulin schedule was maintained for another six months. With no further treatment, the patient's health remains stable 20 months later.
Rewald
M D Enrique
MD
e.rewald@speedy.com.ar
Francischetti
M M
MM
D000368:Aged; D005260:Female; D006461:Hemolysis; D006801:Humans; D007262:Infusions, Intravenous; D007518:Isoantibodies / Q000008:administration & dosage*; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood* / Q000276:immunology*; D018029:Rho(D) Immune Globulin / Q000008:administration & dosage* / Q000009:adverse effects*; D013997:Time Factors
D007518:Isoantibodies; C061961:RHO(D) antibody; D018029:Rho(D) Immune Globulin