Blut

, Volume 47, Issue 2, pp 69–75 | Cite as

Clinical effect of intravenous immunoglobulin on chronic idiopathic thrombocytopenic purpura

  • T. Abe
  • J. Matsuda
  • K. Kawasugi
  • Y. Yoshimura
  • T. Kinoshita
  • M. Kazama
Original Articles

Summary

High dose immunoglobulin infusions showed a marked effect on platelet counts in eight out of nine chronic ITP patients and in one SLE patient. In the comparison of different IgG-preparations, the pepsin treated IgG F (ab′)2 showed no platelet elevation while the sulfonated did. The elevated platelet count could not be maintained after discontinuation of IgG infusions, but in six out of ten patients the platelet level remained above the pretreatment values. This new treatment seems to be safe and effective in adulthood ITP.

Key words

Idiopathic thrombocytopenic purpura in adulthood Intravenous immunoglobulin 

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References

  1. 1.
    Karpatkin S (1980) Autoimmune thrombocytopenic purpura. Blood 56: 329–343PubMedGoogle Scholar
  2. 2.
    McMillan R (1981) Chronic idiopathic thrombocytopenic purpura. N Engl J Med 304: 1135–1147PubMedCrossRefGoogle Scholar
  3. 3.
    Ahn YS, Byrnes JJ, Harrington WJ, Cayer ML, Smith DS, Brunskill DE, Pall LM (1978) The treatment of idiopathic thrombocytopenia with Vinblastin-loaded platelets. N Engl J Med 298: 1101PubMedCrossRefGoogle Scholar
  4. 4.
    Branda RF, McCullough JJ, Tate DY, Jacob HS (1978) Plasma exchange in the treatment of fulminant idiopathic (autoimmune) thrombocytopenic purpura. Lancet I: 688–690CrossRefGoogle Scholar
  5. 5.
    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 I: 1228–1231CrossRefGoogle Scholar
  6. 6.
    Wybran J, Fudenberg HH (1972) Cellular immunity to platelets in idiopathic thrombocytopenic purpura. Blood 40: 856–861PubMedGoogle Scholar
  7. 7.
    Waldschmidt R, Mueller-Eckhardt C (1979) Stimulation of lymphocytes by platelet-antibody-complexes and their role in the pathogenesis of idiopathic thrombocytopenia. Blut 39: 53–60PubMedCrossRefGoogle Scholar
  8. 8.
    Fehr J, Hofmann V, Kappeler U (1982) Transient reversal of thrombocytopenia in idiopathic thrombocytopenic purpura by high-dose intravenous gammaglobulin. N Engl J Med 306: 1254–1258PubMedCrossRefGoogle Scholar
  9. 9.
    Schmidt R, Budde U, Schafer G, Stroehmann I (1981) High-dose intravenous gammaglobulin for idiopathic thrombocytopenic purpura. Lancet II: 475–476CrossRefGoogle Scholar
  10. 10.
    Newland AC, Minchinton RM, Treleaven J, Berney S, Waters AH (1983) High-dose intravenous IgG in adult idiopathic thrombocytopenic purpura. Lancet I: 84–87CrossRefGoogle Scholar
  11. 11.
    McMillan R, Longmire RL, Tavassoli M, Armstrong S, Yelenosky R (1974) In vitro platelet phagocytosis by splenic leukocytes in idiopathic thrombocytopenic purpura. N Engl J Med 290: 249–251PubMedCrossRefGoogle Scholar
  12. 12.
    Shulman NR, Marder VI, Weinrach RS (1965) Similarities between known antiplatelet antibodies and the factor responsible for thrombocytopenia in idiopathic purpura: Physiologic, serologic and isotopic studies. Ann NY Acid Sci 124: 499–542Google Scholar
  13. 13.
    Karpatkin S, Siskin GW (1969) In vitro detection of platelet antibody in patients with idiopathic thrombocytopenic purpura and systemic lupus erythematosus. Blood 33: 759–812Google Scholar
  14. 14.
    Dixon RH, Rosse WF (1975) Platelet antibody in immune thrombocytopenia. Br J Haematol 31: 129–134PubMedGoogle Scholar
  15. 15.
    Dixon R, Rosse WF, Ebbert L (1975) Quantitative determination of antibody in idiopathic thrombocytopenic purpura; correlation of serum and platelet-bound antibody with clinical response. N Engl J Med 292: 230–236PubMedCrossRefGoogle Scholar
  16. 16.
    Hegde UV, Gordon-Smith EC, Worlledge S (1977) Platelet antibodies in thrombocytopenic patients. Br J Haematol 35: 113–122PubMedGoogle Scholar
  17. 17.
    Abe T, Matsuda J (1981) A study of new enzyme immunoassay for quantification of platelet bound IgG and its clinical significance. In: Nydegger UE (ed) Immunohemotherapy. A guide to immunoglobulin prophylaxis and therapy. Academic Press, New York, pp 409–418Google Scholar

Copyright information

© Springer-Verlag 1983

Authors and Affiliations

  • T. Abe
    • 1
  • J. Matsuda
    • 1
  • K. Kawasugi
    • 1
  • Y. Yoshimura
    • 1
  • T. Kinoshita
    • 1
  • M. Kazama
    • 1
  1. 1.1st Internal Medicine, School of MedicineTeikyo UniversityTokyoJapan

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