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IVIG in the Treatment of Children with Acute and Chronic Idiopathic Thrombocytopenic Purpura and the Autoimmune Cytopenias

  • Diane J. Nugent
Part of the Allergy and Immunology book series (ALIM, volume 2)

Abstract

The first therapeutic trial with intravenous immunoglobulin (IVIG) for a disease other than primary or acquired immunodeficiency was described by Paul Imbach et al. in 1981 in children with idiopathic thrombocytopenic purpura (ITP) (1). This study was based on the observation by Imbach and others that patients with primary immunodeficiency or agammaglobulinemia and antiplatelet antibodies had a marked reduction in their thrombocytopenia following routine immunoglobulin infusions (2,3). His landmark paper suggested that IVIG might alter the process of autoantibody- mediated destruction of tissue: in this case, circulating platelets. In the ensuing years, IVIG has been used successfully in an ever-increasing number of autoimmune diseases (4, 5, 6, 7, 8, 9), many of which will be discussed elsewhere in this monograph. To understand the possible mechanisms by which IVIG mediates a resolution of these syndromes, it is important to have a grasp of the basic pathophysiology of the immune cytopenias and current technology used to assess activity of the disease. Following a brief examination of ITP and related cytopenias, we will review the current recommendations for IVIG therapy and discuss various hypotheses as to its mechanism of action.

Keywords

Idiopathic Thrombocytopenic Purpura IVIG Therapy AIHA Patient Antiplatelet Antibody Idiopathic Thrombocytopenic Purpura Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 1992

Authors and Affiliations

  • Diane J. Nugent
    • 1
  1. 1.Division of Hematology-Oncology, Department of PediatricsUniversity of WisconsinMadisonUSA

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