Immune thrombocytopenic purpura intravenous immunoglobulin

Patients with thrombocytopenia generally tolerate intravenous immunoglobulin well (35). In 16 young patients aged 9 months to 22 years with immune-mediated hemocytopenias (13 with childhood immune thrombocytopenic purpura), who received a total of 210 infusions, minimal adverse effects (transient headaches) were experienced during only four infusions, and later infusions were problem-free in three of the four patients (36). 

Tsiouris J, Tsiouris N. Hemiplegia as a comphcation of treatment of childhood immune thrombocytopenic purpura with intravenously administered immunoglobulin. J Pediatr 1998 133(5) 717. 

Berkovitch M, Dolinski G, Tauber T, Aladjem M, Kaplinsky C. Neutropenia as a complication of intravenous immunoglobulin (IVIG) therapy in children with immune thrombocytopenic purpura common and non-alarming. Int J Immunopharmacol 1999 21(6) 411-15. 

Hib Hemophilus influenzae type b HSCT hematopoietic stem cell transplant IMIG intramuscular immunoglobulin IPV inactivated polio vaccine ITP immune thrombocytopenic purpura IVIG intravenous immunoglobulin LAIV live attenuated influenza vaccine MMR measles-mumps-rubeUa vaccine OPV oral polio vaccine... 

Hematologic A 3-year-old boy developed immune thrombocytopenic purpura 26 days after a second dose of seasonal influenza vaccine [12. He was given intravenous immunoglobulin and recovered within 2 days. A literature review showed that symptomatic thrombocytopenia occurs in a substantial number of children and adults who require hospitalization for complicated natural influenza infections. In contrast, reports of immune thrombocytopenic purpura after influenza immunization are rare and occur in adults. 

Robak T, Salama A, Kovaleva L, Vyhovska Y, Davies SV, Mazzucconi MG, Zenker O, Kiessling P. Efficacy and safety of Privigen, a novel liquid intravenous immunoglobulin formulation, in adolescent and adult patients with chronic immune thrombocytopenic purpura. Hematology 2009 14(4) 227-36. 

Idiopathic thrombocytopenic purpura is an immune-mediated disease in which immunoglobulin, either as antibody directed against platelet antigens or nonspecifically bound to platelets, is present in increased quantities on platelets. This leads to increased destruction of platelets and, in many instances, megakaryocytes. Standard treatment consists of corticosteroids and splenectomy (72). When these measures fail, treatment may include androgenic steroids, administration of intravenous 7-globulin, or injection of vinca alkaloids. 

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