Summary
Acute ITP following infection in children has a high rate of spontaneous remission. Since the platelet count is not uncommonly profoundly depressed, ITP is associated with a mortality of around 1%. The aim of treatment in ITP is to prevent bleeding. As a rule, this can only be achieved by normalizing the platelet count. Intravenous immunoglobulin offers certain advantages over conventional steroid therapy. Moreover, two out of three patients with chronic ITP respond to IgG i.v. The characteristic features of ITP in pregnancy, thrombocytopenia in babies born to mothers with ITP and neonatal isoimmune thrombocytopenia are discussed.
Similar content being viewed by others
References
Abe T, Matsuda J, Kawasagi K, Yoshimura Y, Kinoshita T, Kazama M (1983) Clinical effect of intravenous immunoglobulin on chronic idiopathic thrombocytopenic purpura. Blut 47: 96
Bongiovanni A, Mc Padden A (1960) Steroids during pregnancy and possible fetal consequences. Fertil Steril 11: 181
Crosby WH (1975) Wet purpura, dry purpura. JAMA 232: 744
Imbach P, Barandun S, d'Apuzzo V, Baumgartner C, Hirt A, Morell A, Rossi E, Schöni M, Vest M, Wagner HP (1981) High-dose intravenous gammaglobulin for idiopathic thrombocytopenic purpura in childhood. Lancet 1: 1228
Imbach P, Gaedicke G, Joller P (1984) Interim evaluation of the cooperative studies of Immunoglobulin intravenous (IgG i.v.) in childhood idiopathic thrombocytopenic purpura (IgG i.v.) in childhood idiopathic thrombocytopenic purpura (IgG i.v.) in childhood idiopathic thrombocytopenic purpura (ITP): 1. Randomized study comparingh IgG i.v. with oral corticosteroids in previously untreated acute ITP; 2. Prospective study of IgG i.v. in acute and chronic ITP unresponsive to previous treatment. Blut 48: 357
Karpatkin M, Porges R, Karpatkin S (1981) Platelet counts in infants of women with autoimmune thrombocytopenic purpura. N Engl J med 305: 936
Lusher JM, Zuelzer WW (1966) Idiopathic thrombocytopenic purpura in childhood. J Pediatr 68: 971
Lusher JM, Iyer R (1977) Idiopathic thrombocytopenia in children. Semin Thromb Hemostas 3: 175
Mc Millan R (1981) Chronic idiopathic thrombocytopenic purpura. N Engl J med 304: 1135
Mc Williams NB, Maurer HM (1977) Controlled clinical trial of prednisone in childhood ITP. Pediatr Res 11: 476
Mueller-Eckhardt C (1977) Idiopathic thrombocytopenic purpura (ITP). Clinical and immunological considerations. Semin Thromb Hemostas 3: 125
Newland AC, Treleaven JG, Minchinton RM, Waters AH (1983) High-dose intravenous IgG adults with autoimmune thrombocytopenia. Lancet 1: 84
Sartorius JA (1976) Steroid treatment of idiopathic thrombocytopenic purpura in children: preliminary results of a randomized cooperative study. Proc 5th Meeting European Society for Pediatric Hematology and Immunology
Sartorius JA (1984) Steroid treatment of idiopathic thrombocytopenic purpura in children. Results of a randomized cooperative study. Am J Pediatr Hematol Oncol 1: in press
Schulmann I, Currimabhoy Z (1960) Platelet stimulating properties of human plasma with observation on the role of the spleen and the pathogenesis and treatment of ITP. Am J Dis Child 100: 747
Sidiropoulos D, Straume B (1984) The treatment of neonatal isoimmune thrombocytopenia with intravenous immunoglobulin. Blut 48: 383
Stuart JM, Mc Kenna R (1981) Diseases of coagulation: The platelet and vasculature. In: Nathan DG, Oski FA (eds) Hematology of infancy and childhood, Vol II. WB Saunders, Philadelphia London Toronto, pp 1234
Warrel DW, Taylor R (1968) Outcome for the fetus of mothers receiving prednisolone during pregnancy. Lancet 1: 117
Wenske C, Gaedicke G, Küenzlen E, Heyes H, Mueller-Eckhardt C, Kleihauer E, Lauritzen C (1983) Treatment of idiopathic thrombocytic purpura in pregnancy by high-dose intravenous immunoglobulin. Blut 46: 347
Wenske C, Gaedicke G, Heyes H (1984) Idiopathic thrombocytopenic purpura in pregnancy and neonatal period. Blut 48: 377
Zerella JT, Martin LW (1978) Emergency splenectomy for idiopathic thrombocytopenic purpura in children. J Pediatr Surg 13: 243
Zuelzer WW, Lusher JM (1977) Childhood idiopathic thrombocytopenic purpura: To treat or not to treat. Am J Dis Child 131: 360
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Gaedicke, G., Imbach, P. & Kleihauer, E. The place of intravenous immunoglobulin (IgG i.v.) therapy in thrombocytopenia. Blut 48, 409–413 (1984). https://doi.org/10.1007/BF00319973
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00319973