Acute renal failure after intravenous anti-D immune globulin in an adult with immune thrombocytopenic purpura

被引:12
作者
Chun, NS
Savani, B
Seder, RH
Taplin, ME
机构
[1] Univ Massachusetts, Mem Med Ctr, Dept Med, Div Hematol Oncol, Worcester, MA 01655 USA
[2] Univ Massachusetts, Ctr Med, Dept Med, Worcester, MA 01605 USA
[3] Univ Massachusetts, Mem Med Ctr, Dept Hosp Labs, Worcester, MA 01655 USA
关键词
anti-D immune globulin; acute renal failure; hemodialysis; intravascular hemolysis; immune thrombocytopenic purpura;
D O I
10.1002/ajh.10432
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Intravenous anti-D immune globulin (anti-D IGIV) is indicated for the treatment of immune thrombocytopenic purpura (ITP) in nonsplenectomized patients who are Rh(D)-positive. Recent reports have described episodes of intravascular hemolysis (IVH) and acute renal failure (ARF) after anti-D IGIV. We report the first adult patient with ITP who required and received dialysis after IVH and ARF complicating treatment with anti-D IGIV. Whether the transfusion of 2 units of Rh(D)-positive red cells, indicated for the resulting anemia, exacerbated the IVH and renal failure is unclear. Three weeks after the administration of anti-D IGIV (13 days after two hemodialysis treatments), the patient's renal function had returned to normal. This case highlights the infrequent but potentially serious side effects of anti-D IGIV and the need to monitor a patient's renal function closely if there is evidence of IVH after infusion of anti-D IGIV. If red cell transfusion is indicated, we recommend the use of Rh(D)-negative red cell products. (C) 2003 Wiley-Liss, Inc.
引用
收藏
页码:276 / 279
页数:4
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