title: Treatment of an infant with severe acute refractory immune thrombocytopenic purpura using combination therapy including rituximab.
abstract: Some infants with acute immune thrombocytopenic purpura (ITP) do not respond to first-line therapy, and currently there is no consensus on therapy for these refractory cases. We describe a 12-week-old infant with acute ITP who was unresponsive to intravenous immunoglobulin and corticosteroid, and developed gastrointestinal bleeding. Several combination therapies were unsuccessful. After four doses of rituximab followed by intravenous immunoglobulin and corticosteroid, his platelet counts gradually increased. Combined therapy which includes rituximab may be a promising treatment for severe acute refractory ITP.
authors.affiliation: Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Kotoe
authors.initials: K
authors.lastname: Iesato
authors.forename: Naoki
authors.initials: N
authors.lastname: Hatakeyama
authors.forename: Masaki
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Hori
authors.forename: Natsuko
authors.initials: N
authors.lastname: Inazawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsutsumi
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Suzuki
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D058846:Antibodies, Monoclonal, Murine-Derived; D004359:Drug Therapy, Combination; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage; D007155:Immunologic Factors / Q000008:administration & dosage*; D007223:Infant; D008297:Male; D011241:Prednisone / Q000008:administration & dosage; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy* / Q000503:physiopathology; D000069283:Rituximab
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D000069283:Rituximab; D011241:Prednisone