Single dose of ANTI-D immune globulin at 75μg/kg is as effective as intravenous immune globulin at rapidly raising the platelet count in newly diagnosed immune thrombocytopenic purpura in children

Objective To conduct a randomized prospective trial of immuune globulin treatment for 105 Rh+ children with newly-diagnosed immune thrombocytopenic purpura and a platelet count < 20.000/mu L, to determine whether anti-D immune globulin (anti-D) is as effective as intravenous immue globulin (IVIg). Study design Eligible patients received either a single intravenous dose of 50 mu g/kg anti-D (anti-D50), 75 mu g/kg anti-D, (anti-D75), or 0.8 g/kg IVIg, (IVI g). Patients were monitored for response to treatment and adverse events. Results By 24 hours after treatment 50%, 72%, and 77% of patients in the anti-D50, anti-D75, and IVIg groups, respectively, had achieved a platelet count > 20,000/mu l. (P = .03). By day 7, hemoglobin concentrations decreased by 1.6 g/dL, 2 g/dL, and 0.3 g/dL in the anti-D50, anti-D 7 5, and IVIg groups, respectively. Headache, fever. or chills occurred least often in the anti-D50 group. Conclusions A single 75 mu g/kg dose of Anti-D raised the platelet count in children with newly diagnosed immune thrombocytopenic purpura more rapidly than standard-dose anti-D and as effectively as IVIg. with an acceptable safety profile.