Anti-D immunoglobulin treatment for thrombocytopenia associated with primary antibody deficiency
- 1Department of Immunopathology, Barts and The London NHS Trust, London EC1A 7BE, UK
- 2Department of Haematology, Barts and The London NHS Trust
- 3Department of Haematology, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK
- 4Department of Haematology, Bromley Hospitals NHS Trust, London BR6 8ND, UK
- 5Department of Haematology, Havering Hospitals NHS Trust, Romford RM3 OBE, UK
- Correspondence to: Dr H Longhurst, Department of Immunopathology, St Bartholomew's Hospital, 51–53 Bartholomew Close, London EC1A 7BE, UK; hlonghurst{at}doctors.org.uk
- Accepted 1 August 2001
Abstract
Aims: To review our experience of anti-D immunoglobulin for immune thrombocytopenia (ITP) in patients with primary antibody deficiency.
Methods/patients: A retrospective case notes review of four Rhesus positive patients with ITP and primary antibody deficiency, treated with anti-D. Patients were refractory to steroids and high dose intravenous immunoglobulin (IVIG). Two patients were previously splenectomised.
Results: All patients responded to anti-D immunoglobulin. Improved platelet counts were sustained for at least three months. Side effects included a fall in haemoglobin in all cases; one patient required red blood cell transfusion. Two patients had transient neutropenia (< 1 × 109/litre).
Conclusion: Anti-D immunoglobulin may be an effective treatment for antibody deficiency associated thrombocytopenia, even after splenectomy. Anti-D immunoglobulin may have considerable clinical advantages in this group of patients, where treatments resulting in further immunosuppression are relatively contraindicated.
- CVID, common variable immunodeficiency
- ITP, immune thrombocytopenia
- IVIG, intravenous immunoglobulin
- NA, not applicable
