title: Safety and Efficacy of a Single Dose of Anti-D (WinRho®) in Severe Thrombocytopenia Secondary to Dengue Virus Infection.
abstract: OBJECTIVE
  To evaluate the efficacy of a single intravenous (IV) dose of anti-D in severe thrombocytopenia (<20,000) due to dengue virus (DEV) infection.
  
  
  METHODS
  An open label, investigator-initiated, randomized interventional study was conducted that included thirty dengue patients (all positive for IgM enzyme-linked immunosorbent assay) with severe thrombocytopenia (<20,000/mm3). Patients were randomized to receive anti-D (50 μg/kg single IV dose) plus supportive therapy or supportive therapy alone.
  
  
  RESULTS
  The rate of rise in platelet count was significantly high in the intervention group at 24, 36, and 48 h. At the end of 48 h, 60% patients in the intervention group achieved a platelet count of ≥50,000/mm3as compared to 6.7% in the control group (P= 0.0019). The requirement of the platelet concentrate infusion in the control group was significantly higher, i.e. 342 ml (±193) as compared to the intervention group requiring only 187 ml (±79). The intervention group showed a significant improvement in bleeding manifestations in all the patients by 24 h in Grade 2 bleed (P= 0.032) and by 48 h in Grade 1 bleed (P= 0.014).
  
  
  CONCLUSIONS
  Severe thrombocytopenia (≤20,000/mm3) secondary to DEV infection was rapidly and safely reversed by administration of a single dose of 50 μg/kg (250 IU/kg) anti-D IV.
authors.affiliation: Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Ashok Kumar
authors.initials: AK
authors.lastname: Pannu
authors.affiliation: Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Ashish
authors.initials: A
authors.lastname: Bhalla
authors.affiliation: Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Mayank
authors.initials: M
authors.lastname: Singhal
authors.affiliation: Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Suri
authors.affiliation: Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Nusrat
authors.initials: N
authors.lastname: Shafiq
authors.affiliation: Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Subhash
authors.initials: S
authors.lastname: Varma
keywords: Anti-D; dengue; thrombocytopenia