Abstract
Platelet associated immune globulin was studied during the course of ITP in 15 children; the microtiter solid phase immunoassay was used.Values in 10 patients with acute ITP were compared with those in 5 children with chronic ITP.
At the onset,PAIgG was elevated in 9/10 children with acute ITP;8/10 had levels>70fg/pl (median PAIgG=91.7;normal=<5.2fg/pl) The one child with acute ITP whose PAIgG was normal recovered within two weeks.At recovery PAIgG levels had fallen below 10fg/pl(median 3.7 fg/pl) in 7/8;5/7 had normal levels.
In contrast, 4/5 children whose disease became chronic, had lower levels of PAIgG (<16.7fg/pl).Only 1/5 chronic ITP patients had markedly elevated PAIgG. In 2 patients post-splenectomy, levels were normal even in transient periods of thrombocytopenia. In one patient,PAIgG rose dramatically to 75 fg/pl during an intercurrent viral illness. Another patient's PAIgG levels rose transiently following treatment with IV gamma globulin; no change in the platelet count occurred.
These findings suggest that PAIgG is usually higher at the onset of classic childhood ITP (acute) than in those children whose course becomes chronic although the levels are not individually predictive. The observed drop in PAIgG after splenectomy as well as the sharp rises noted during infection and gammaglobulin treatment deserve further study to help understand the relationship between thrombocytopenia and PAIgG.
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Brown, A., Gowda, N., Miller, S. et al. PLATELET ASSOCIATED IMMUNE GLOBULIN(PAIg) IN THE COURSE OF CHILDHOOD IDIOPATHIC THROMBOCYTOPENIC PURPURA. Pediatr Res 18 (Suppl 4), 236 (1984). https://doi.org/10.1203/00006450-198404001-00860
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DOI: https://doi.org/10.1203/00006450-198404001-00860