Anti-D immunoglobulin treatment for thrombocytopenia associated with primary antibody deficiency.
Author(s): Longhurst HJ, O'Grady C, Evans G, De Lord C, Hughes A, Cavenagh J, Helbert MR
Affiliation(s): Department of Immunopathology, Barts and The London NHS Trust, London EC1A 7BE, UK. email@example.com
Publication date & source: 2002-01, J Clin Pathol., 55(1):64-6.
Publication type: Case Reports
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.