Objective: To conduct a randomized prospective trial of immune globulin treatment for 105 Rh+ children with newly diagnosed immune thrombocytopenic purpura and a platelet count < 20,000/μ L, to determine whether a...Objective: To conduct a randomized prospective trial of immune globulin treatment for 105 Rh+ children with newly diagnosed immune thrombocytopenic purpura and a platelet count < 20,000/μ L, to determine whether anti- D immune globulin (anti- D) is as effective as intravenous immune globulin (IVIg). Study design: Eligible patients received either a single intravenous dose of 50 μ g/kg anti- D (anti- D50), 75 μ g/kg anti- D, (anti- D75), or 0.8 g/kg IVIg,(IVIg). Patients were monitored for response to treatment and adverse events. Results: By 24 hours after treatment 50% , 72% , and 77% of patients in the anti- D50, anti- D75, and IVIg groups, respectively, had achieved a platelet count > 20,000/μ L (P = 0.03). By day 7, hemoglobin concentrations decreased by 1.6 g/dL, 2 g/dL, and 0.3 g/dL in the anti- D50, anti- D75, and IVIg groups, respectively. Headache, fever, or chills occurred least often in the anti- D50 group. Conclusions: A single 75μ g/kg dose of Anti- D raised the platelet count in children with newly diagnosed immune thrombocytopenic purpura more rapidly than standard- dose anti- D and as effectively as IVIg, with an acceptable safety profile.展开更多
文摘Objective: To conduct a randomized prospective trial of immune globulin treatment for 105 Rh+ children with newly diagnosed immune thrombocytopenic purpura and a platelet count < 20,000/μ L, to determine whether anti- D immune globulin (anti- D) is as effective as intravenous immune globulin (IVIg). Study design: Eligible patients received either a single intravenous dose of 50 μ g/kg anti- D (anti- D50), 75 μ g/kg anti- D, (anti- D75), or 0.8 g/kg IVIg,(IVIg). Patients were monitored for response to treatment and adverse events. Results: By 24 hours after treatment 50% , 72% , and 77% of patients in the anti- D50, anti- D75, and IVIg groups, respectively, had achieved a platelet count > 20,000/μ L (P = 0.03). By day 7, hemoglobin concentrations decreased by 1.6 g/dL, 2 g/dL, and 0.3 g/dL in the anti- D50, anti- D75, and IVIg groups, respectively. Headache, fever, or chills occurred least often in the anti- D50 group. Conclusions: A single 75μ g/kg dose of Anti- D raised the platelet count in children with newly diagnosed immune thrombocytopenic purpura more rapidly than standard- dose anti- D and as effectively as IVIg, with an acceptable safety profile.
