Shahgholi Elham, Vosough Parvaneh, Sotoudeh Kambiz, Arjomandi Khadijeh, Ansari Shahla, Salehi Soraya, Faranoush Mohammad, Ehsani Mohammad Ali
Division of Hematology/Oncology, Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran.
Indian J Pediatr. 2008 Dec;75(12):1231-5. doi: 10.1007/s12098-008-0243-y. Epub 2009 Feb 4.
The purpose of this study was to compare the efficacy and side effects of intravenous immunoglobulin (IVIG) with intravenous anti-D immunoglobulin for treatment of newly diagnosed acute childhood Idiopathic thrombocytopenic purpura (ITP).
Children (6 months to 14 years) with newly diagnosed acute ITP and platelet count below 20,000/ microL were randomized to receive single dose intravenous 75 microg/kg anti-D or 1g/kg IVIG for two consecutive days (total dose 2 g/kg). Response rate defined as a platelet count over 20,000 / microL 72 hours after initial treatment.
Eighty one patients (52 male and 29 female) with mean age of 5 years and 3 months randomly divided in anti-D group (n=42) and IVIG group (n=39). Mean baseline (pretreatment) platelet counts were 15406 / microL and 15230/ microL in anti-D and IVIG group, respectively. The response rate in IVIG group (98%) was more significant than anti-D group (76%); (P = 0.017). After 7 days the platelet counts of all patients in IVIG group were more than 20,000/ microL while in anti-D group 12% had platelet counts below 20,000/ microL.
In acute childhood ITP, initial treatment with IVIG (2g/Kg in divided dose) increased platelet count more rapidly and more significant than intravenous anti-D (single dose of 75 microg/kg) within the first 72 hours.
本研究旨在比较静脉注射免疫球蛋白（IVIG）与静脉注射抗D免疫球蛋白治疗新诊断的儿童急性特发性血小板减少性紫癜（ITP）的疗效和副作用。
将新诊断为急性ITP且血小板计数低于20,000/微升的6个月至14岁儿童随机分为两组，一组连续两天接受单剂量静脉注射75微克/千克抗D免疫球蛋白，另一组连续两天接受1克/千克IVIG（总剂量2克/千克）。反应率定义为初始治疗72小时后血小板计数超过20,000/微升。
81例患者（男52例，女29例），平均年龄5岁3个月，随机分为抗D组（n = 42）和IVIG组（n = 39）。抗D组和IVIG组的平均基线（治疗前）血小板计数分别为15406/微升和15230/微升。IVIG组的反应率（98%）高于抗D组（76%）；（P = 0.017）。7天后，IVIG组所有患者的血小板计数均超过20,000/微升，而抗D组有12%的患者血小板计数低于20,000/微升。
在儿童急性ITP中，初始使用IVIG（分剂量2克/千克）治疗在最初72小时内比静脉注射抗D（单剂量75微克/千克）更迅速、更显著地提高血小板计数。
