Intravenous Immunoglobulin Therapy (1.0 g/kg, 1 time) for Acute Idiopathic Thrombocytopenic Purpura in Childhood

Abstract

We evaluated the efficacy of a single administration of half the dose of intravenous immunoglobulin (IVIg) recommended in current therapy to reduce bleeding tendencies and increase platelet counts. Nine cases with idiopathic thrombocytopenic purpura were treated one time with IVIg (1.0 g/kg). Platelet counts before treatment were 0.97 ± 0.6×10⁴/μl. After IVIg treatment, the bleeding tendency improved in all cases, andplatelet counts on the following day were 4.6 ± 2.6×10⁴/μl. Platelet counts increased to more than 5.0×10⁴/μl over an average of 2.2 days, and in 7 out of 9 cases, platelet counts increased by this amount in less than 2 days. Subsequently, 3 cases maintained normal platelet counts without further therapy, while in the other cases, theplatelet count remained at more than 5.0×10⁴/μl for 2 to 17 days. No side effects appeared in any of the cases.We conclude that a single-administration IVIg therapy (1.0 g/kg) seems as effective as the currently recommended therapy in promoting an early increase in platelet counts and in reducing bleeding tendencies. However, a controlled study using a larger number of cases must be carried out.