Lack of efficacy of high-dose intravenous immunoglobulin treatment of severe thrombocytopenia in patients with secondary dengue virus infection.
Because most cases of secondary dengue virus infection are associated with an increased level of platelet-associated IgG, a high dose of intravenous immunoglobulin (IVIG) may have an effect on the development of severe thrombocytopenia in this disease. A randomized, controlled study was conducted with two treatment groups consisting of a treatment (IVIG) group (n = 15) and a non-treatment (non-IVIG) group (n = 16) to determine whether a high dose of IVIG is effective in hastening the recovery from thrombocytopenia in patients with secondary dengue virus infection. No significant difference was found in the baseline demographic data between the two groups. No adverse effect of IVIG was observed, but no effect in hastening the recovery of platelet counts was found in patients with secondary dengue infections. The lack of efficacy of IVIG suggests that platelet clearance by macrophages through Fc gamma receptors is not a primary mechanism in this disease.
Dimaano
Efren M
EM
Department of Blood Borne Diseases, San Lazaro Hospital, Manila, Research and Biotechnology Division, St. Luke's Medical Center, Quezon City, The Philippines .
Saito
Mariko
M
Honda
Shoko
S
Miranda
Edna A
EA
Alonzo
Maria T G
MT
Valerio
Myra D
MD
Mapua
Cynthia A
CA
Inoue
Shingo
S
Kumaori
Atsushi
A
Matias
Ronald
R
Natividad
Filipinas F
FF
Oishi
Kazunori
K
D000293:Adolescent; D000328:Adult; D001792:Blood Platelets / Q000187:drug effects / Q000276:immunology; D002648:Child; D003715:Dengue / Q000150:complications* / Q000821:virology; D003716:Dengue Virus / Q000276:immunology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage* / Q000494:pharmacology; D007155:Immunologic Factors / Q000008:administration & dosage* / Q000494:pharmacology; D008297:Male; D010679:Philippines; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy* / Q000209:etiology* / Q000276:immunology / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome
D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors