Abstract
Eight patients with acute ITP steroid resistant (SR) to 2-4 mg/kg/day of prednisone for 1 to 6 weeks received 1 gm/kg/day IVGG up to 3 consecutive days depending on response. The table compares platelet count and IVGG treatments of the 8 SR patients with 10 previously untreated (U) acute ITP patients:
No SR patient still requires treatment: 5 are in remission and the 3 non-remission patients average 97,000/ul. The outcome of the U patients is 4 remission, 5 stable without therapy and 1 refractory (not different from the SR group). 4/10 U patients and 2/8 SR patients received only a single infusion total; 3/10 U patients and 1/8 SR patients received only 2 infusions. Sixteen patients were treated with Immuno IVGG, 2 with Sandoglobulin and no side effects were seen. Neither initial platelet count, platelet size, PAIgG, PAIgM, C3, C4, CH50 nor serum immunoglobulin levels differentiated the SR vs U groups or predicted which patients would respond better to IVGG. In summary, IVGG effectively treated steroid resistant acute ITP patients (presumably the group at highest risk for intracranial hemorrhage) with rapid increases in the platelet count and excellent outcomes comparable to previously untreated patients. The only difference between the SR & U pts was the increased use of IVGG.
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Bussel, J., Hilgartner, M. GOOD RESPONSE TO INTRAVENOUS GAMMAGLOBULIN OF PATIENTS WITH STEROID RESISTANT ACUTE ITP. Pediatr Res 18 (Suppl 4), 237 (1984). https://doi.org/10.1203/00006450-198404001-00863
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DOI: https://doi.org/10.1203/00006450-198404001-00863