Anti-D immunoglobulin treatment for thrombocytopenia associated with primary antibody deficiency |
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Authors: | Longhurst H J O'Grady C Evans G De Lord C Hughes A Cavenagh J Helbert M R |
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Affiliation: | Department of Immunopathology, Barts and The London NHS Trust, London EC1A 7BE, UK. hlonghurst@doctors.org.uk |
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Abstract: | AIMS: To review our experience of anti-D immunoglobulin for immune thrombocytopenia (ITP) in patients with primary antibody deficiency. METHODS/PATIENTS: A retrospective case notes review of four Rhesus positive patients with ITP and primary antibody deficiency, treated with anti-D. Patients were refractory to steroids and high dose intravenous immunoglobulin (IVIG). Two patients were previously splenectomised. RESULTS: All patients responded to anti-D immunoglobulin. Improved platelet counts were sustained for at least three months. Side effects included a fall in haemoglobin in all cases; one patient required red blood cell transfusion. Two patients had transient neutropenia (< 1 x 10(9)/litre). CONCLUSION: Anti-D immunoglobulin may be an effective treatment for antibody deficiency associated thrombocytopenia, even after splenectomy. Anti-D immunoglobulin may have considerable clinical advantages in this group of patients, where treatments resulting in further immunosuppression are relatively contraindicated. |
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