Abstract
Three children with chronic idiopathic thrombocytopenic purpura (ITP) were treated by repetitive (monthly) high-dose (1 g/kg) intravenous gammaglobulin, which was started 4-6 years after the onset of ITP. Excellent effects were observed in 2 cases 5-6 months after initiation of therapy and they remained in complete remission for more than 2years. In the third case, the elevation of platelet counts was transient, though bleeding tendency was markedly relieved. Immunologically, platelet-associated IgG, natural killer (NK) cell activity, and lymphokine activated killer (LAK) cell activity were normalized by high-dose gammaglobulin therapy in all three cases, though the effects were transient in the third case in whom consistently elevated CD8+HLADR+ (activated T suppressor) lymphocytes and inverted CD4/CD8 ratio were observed. Headache of short duration was the only adverse effect, in the first case. We would like to emphasize that monthly high-dose (1 g/kg) gammaglobulin therapy in effective in treating chronic ITP both clinically and immunologically, and complete remission may be attained by this therapy.
