title: Standard-dose intravenous anti-D immunoglobulin versus intravenous immunoglobulin in the treatment of newly diagnosed childhood primary immune thrombocytopenia.
abstract: BACKGROUND
  We conducted a study to evaluate the efficacy of intravenous (IV) anti-D against IV immunoglobulin (IVIG) in newly diagnosed immune thrombocytopenia (ITP) in children and to identify the clinical characteristics of the children most likely to benefit from one or the other treatment.
  
  
  METHODS
  Children (6 mo to 14 y) with newly diagnosed ITP and a platelet count <20,000/μL were treated either with a single bolus dose of 50 μg/kg IV anti-D or with 0.8 to 1 g/kg IVIG in a randomized manner.
  
  
  RESULTS
  Twenty-five patients, mean age of 6.8 years, were treated either with IV anti-D (n=10) or with IVIG (n=15). Both drugs were equally efficient in raising the platelet count above 20,000/μL at 24 hours posttreatment. Children who presented with bleeding stage 1 or 2 (no mucosal bleeding) responded better to IVIG treatment, in terms of an increase in platelet count at 24 hours posttreatment (P=0.04). Hemoglobin drop was greater in the anti-D group (P=0.002).
  
  
  CONCLUSIONS
  A single bolus dose of 50 μg/kg of IV anti-D is a safe and effective first-line treatment in newly diagnosed ITP in childhood and mucosal bleeding is a poor prognostic factor for treatment with IVIG.
authors.affiliation: First Pediatric Department of Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece. andromachipap@hotmail.com
authors.forename: Andromachi
authors.initials: A
authors.lastname: Papagianni
authors.forename: Marina
authors.initials: M
authors.lastname: Economou
authors.forename: Athanasios
authors.initials: A
authors.lastname: Tragiannidis
authors.forename: Eliza
authors.initials: E
authors.lastname: Karatza
authors.forename: Ioanna
authors.initials: I
authors.lastname: Tsatra
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Gombakis
authors.forename: Fani
authors.initials: F
authors.lastname: Athanassiadou-Piperopoulou
authors.forename: Miranda
authors.initials: M
authors.lastname: Athanasiou-Metaxa
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004306:Dose-Response Relationship, Immunologic; D005260:Female; D006470:Hemorrhage / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage* / Q000009:adverse effects; D007223:Infant; D007518:Isoantibodies / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D010976:Platelet Count; D011446:Prospective Studies; D020551:Pulse Therapy, Drug; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology*; D018029:Rho(D) Immune Globulin; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous; D007518:Isoantibodies; C061961:RHO(D) antibody; D018029:Rho(D) Immune Globulin