Suarez C R, Anderson C
Stritch School of Medicine, Loyola University, Maywood, Illinois.
Am J Hematol. 1987 Nov;26(3):247-53. doi: 10.1002/ajh.2830260306.
Recent reports suggest that intravenous gammaglobulin (IVG) may be an effective treatment modality in patients with immune thrombocytopenia (ITP). Two newborns with isoimmune thrombocytopenia secondary to HLA-A2 and PLA1 platelet antigen incompatibilities with their respective mothers and two newborns with thrombocytopenia secondary to maternal ITP were treated with IVG 400 mg/kg/day x 5 days. One patient was exposed to steroids in utero; only one mother was thrombocytopenic at the time of delivery. All patients were severely thrombocytopenic on day 1 of treatment with mean platelet count of 5.7 x 10(9)/L. All had petechiae and positive quaiac stools, and patients with isoimmune thrombocytopenia had CT scan evidence of intracranial bleeds. The mean platelet count after 24 hr was 26.7 x 10(9)/L and the average platelet increase was 21 x 10(9)/L and 33 x 10(9)/L at 24 and 48 hr, respectively. The two cases with isoimmune thrombocytopenia had sustained platelet increases; the two cases secondary to maternal ITP had transient platelet elevations. IVG can rapidly elevate the platelet count in these patients, especially those with severe bleeding manifestations.
近期报告表明，静脉注射丙种球蛋白（IVG）可能是免疫性血小板减少症（ITP）患者的一种有效治疗方式。两名因HLA - A2和PLA1血小板抗原与其各自母亲不相容而患有同种免疫性血小板减少症的新生儿，以及两名因母亲患ITP而患有血小板减少症的新生儿，接受了IVG治疗，剂量为400 mg/kg/天，共5天。一名患者在子宫内接触过类固醇；只有一名母亲在分娩时血小板减少。所有患者在治疗第1天均严重血小板减少，平均血小板计数为5.7×10⁹/L。所有患者均有瘀点和大便潜血阳性，患有同种免疫性血小板减少症的患者CT扫描有颅内出血证据。24小时后的平均血小板计数为26.7×10⁹/L，24小时和48小时时血小板平均增加值分别为21×10⁹/L和33×10⁹/L。两名患有同种免疫性血小板减少症的病例血小板持续增加；两名因母亲患ITP继发的病例血小板短暂升高。IVG可迅速提高这些患者的血小板计数，尤其是那些有严重出血表现的患者。
