Successful intravenous immunoglobulin therapy for two patients who developed immune thrombocytopenia during the convalescent phase of Kawasaki disease

Abstract

Here, we report the cases of two patients who presented with immune thrombocytopenia (ITP) after receiving intravenous immunoglobulins (IVIGs) for the treatment of their Kawasaki disease (KD). In addition to IVIGs, they were also administered oral aspirin. Although their KD symptoms were promptly ameliorated, the platelet counts of the first and second patients decreased 13 and 21 days after the diagnosis of KD, respectively. The complication was diagnosed as ITP, and they received further IVIG therapy using another type of immunoglobulin, after which the patients’ platelet counts increased. There have been few reports on KD complicated by ITP, and none of the reported cases involved IVIG therapy. Our patients received another type of IVIG for their ITP in addition to IVIGs administered for their KD, and their platelet counts promptly increased. Our cases suggest that IVIG therapy is a treatment option for ITP that arises after the administration of IVIGs for KD. However, IVIGs should be used carefully because of the risk of IVIG thrombosis.