抗-D免疫球蛋白治疗与原发性抗体缺陷相关的血小板减少症。
Anti-D immunoglobulin treatment for thrombocytopenia associated with primary antibody deficiency.
作者信息
Longhurst H J, O'Grady C, Evans G, De Lord C, Hughes A, Cavenagh J, Helbert M R
机构信息
Department of Immunopathology, Barts and The London NHS Trust, London EC1A 7BE, UK.
出版信息
J Clin Pathol. 2002 Jan;55(1):64-6. doi: 10.1136/jcp.55.1.64.
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 x 10(9)/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.
目的
回顾我们使用抗D免疫球蛋白治疗原发性抗体缺陷患者免疫性血小板减少症（ITP）的经验。
方法/患者：对4例接受抗D治疗的恒河猴阳性ITP和原发性抗体缺陷患者进行回顾性病例记录审查。患者对类固醇和大剂量静脉注射免疫球蛋白（IVIG）难治。2例患者先前已行脾切除术。
结果
所有患者对抗D免疫球蛋白均有反应。血小板计数改善持续至少3个月。副作用包括所有病例血红蛋白下降；1例患者需要输注红细胞。2例患者出现短暂性中性粒细胞减少（<1×10⁹/升）。
结论
抗D免疫球蛋白可能是治疗抗体缺陷相关血小板减少症的有效方法，即使在脾切除术后也是如此。在这组患者中，抗D免疫球蛋白可能具有相当大的临床优势，因为导致进一步免疫抑制的治疗相对禁忌。
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