Successful intravenous immune globulin therapy for human immunodeficiency virus-associated thrombocytopenia.

High-dose intravenous (IV) immune globulin was used to treat human immunodeficiency virus (HIV)-associated thrombocytopenia four times in three patients. The average platelet count at initiation of therapy was 12 x 10(9)/L (12 x 10(3)/mm3), and the platelet count after therapy was 159 x 10(9)/L (159 x 10(3)/mm3), giving a mean increase of 147 x 10(9)/L (147 x 10(3)/mm3) (1225%). The conditions of two of these patients were refractory to corticosteroids, but giving IV immune globulin along with steroids appeared to enhance the response to IV immune globulin. A review of the literature revealed that 53 (88%) of 60 patients with HIV-associated thrombocytopenia responded to IV immune globulin with platelet counts greater than 50 x 10(9)/L (50 x 10(3)/mm3). We conclude that IV immune globulin therapy achieves transient elevations in platelet counts to levels that control bleeding and permit surgery in patients with severe, HIV-associated thrombocytopenia.