Single dose of anti-D immune globulin at 75 microg/kg is as effective as intravenous immune globulin at rapidly raising the platelet count in newly diagnosed immune thrombocytopenic purpura in children.
OBJECTIVE
To conduct a randomized prospective trial of immune globulin treatment for 105 Rh+ children with newly-diagnosed immune thrombocytopenic purpura and a platelet count<20,000/microL, to determine whether anti-D immune globulin (anti-D) is as effective as intravenous immune globulin (IVIg).


METHODS
Eligible patients received either a single intravenous dose of 50 microg/kg anti-D (anti-D50), 75 microg/kg anti-D, (anti-D75), or 0.8 g/kg IVIg, (IVIg). Patients were monitored for response to treatment and adverse events.


RESULTS
By 24 hours after treatment 50%, 72%, and 77% of patients in the anti-D50, anti-D75, and IVIg groups, respectively, had achieved a platelet count>20,000/microL (P=.03). By day 7, hemoglobin concentrations decreased by 1.6 g/dL, 2 g/dL, and 0.3 g/dL in the anti-D50, anti-D75, and IVIg groups, respectively. Headache, fever, or chills occurred least often in the anti-D50 group.


CONCLUSIONS
A single 75 microg/kg dose of Anti-D raised the platelet count in children with newly diagnosed immune thrombocytopenic purpura more rapidly than standard-dose anti-D and as effectively as IVIg, with an acceptable safety profile.
Tarantino
Michael D
MD
Comprehensive Bleeding Disorders Center, University of Illinois College of Medicine, Peoria, Illinois 61614, and Children's Hospital of Orange County, Orange, California, USA. mdtara@hemophilia-ctr-peoria.com
Young
Guy
G
Bertolone
Salvatore J
SJ
Kalinyak
Karen A
KA
Shafer
Frank E
FE
Kulkarni
Roshni
R
Weber
Lisa C
LC
Davis
Mary L
ML
Lynn
Henry
H
Nugent
Diane J
DJ
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D007223:Infant; D008297:Male; D010976:Platelet Count; D011446:Prospective Studies; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000188:drug therapy*; D018029:Rho(D) Immune Globulin / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology
D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D018029:Rho(D) Immune Globulin