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Swain TR, Jena RK, Swain KP. High dose Intravenous Anti-D Immune Globulin is More Effective and Safe in Indian Paediatric Patients of Immune Thrombocytopenic Purpura. J Clin Diagn Res. 2016;10(12):FC12-FC15doi: 10.7860/JCDR/2016/20347.8976.
Swain, T. R., Jena, R. K., & Swain, K. P. (2016). High dose Intravenous Anti-D Immune Globulin is More Effective and Safe in Indian Paediatric Patients of Immune Thrombocytopenic Purpura. Journal of clinical and diagnostic research : JCDR, 10(12), FC12-FC15. https://doi.org/10.7860/JCDR/2016/20347.8976
Swain, Trupti Rekha, et al. "High dose Intravenous Anti-D Immune Globulin is More Effective and Safe in Indian Paediatric Patients of Immune Thrombocytopenic Purpura." Journal of clinical and diagnostic research : JCDR vol. 10,12 (2016): FC12-FC15. doi: https://doi.org/10.7860/JCDR/2016/20347.8976
Swain TR, Jena RK, Swain KP. High dose Intravenous Anti-D Immune Globulin is More Effective and Safe in Indian Paediatric Patients of Immune Thrombocytopenic Purpura. J Clin Diagn Res. 2016 Dec;10(12):FC12-FC15. doi: 10.7860/JCDR/2016/20347.8976. Epub 2016 Dec 01. PMID: 28208873; PMCID: PMC5296446.
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J Clin Diagn Res. 2016 Dec;10(12):FC12-FC15. doi: 10.7860/JCDR/2016/20347.8976. Epub 2016 Dec 01.

High dose Intravenous Anti-D Immune Globulin is More Effective and Safe in Indian Paediatric Patients of Immune Thrombocytopenic Purpura.

Journal of clinical and diagnostic research : JCDR

Trupti Rekha Swain, Rabindra Kumar Jena, Kali Prasanna Swain

Affiliations

  1. Associate Professor and In charge, Clinical Pharmacology Unit, Department of Pharmacology, SCB Medical College and Hospital , Cuttack, Odisha, India .
  2. Head, Department of Clinical Haematology, SCB Medical College , Cuttack, Odisha, India .
  3. Assistant Professor, Department of Neurology, SCB Medical College , Cuttack, Odisha, India .

PMID: 28208873 PMCID: PMC5296446 DOI: 10.7860/JCDR/2016/20347.8976

Abstract

INTRODUCTION: Immune Thrombocytopenia (ITP) is characterised by an autoimmune antibody-mediated destruction of platelets and impaired platelet production. Few controlled trials exist to guide management of patients with ITP in Indian scenario for which patients require an individualized approach. Anti-D (Rho (D) immune globulin) at a higher dose can prove to be a cost effective and safe alternative for Indian patients with ITP.

AIM: To compare the safety and efficacy of higher dose (75μg/kg) intravenous Anti-D immune globulin against the standard dose of 50μg/kg for the management of ITP in Indian patients.

MATERIALS AND METHODS: One hundred and sixty four children with newly diagnosed ITP between 4-14 years were randomly selected for inclusion and were treated with 50μg/kg (standard dose) or 75μg /kg (higher dose) of Anti-D to compare the efficacy and safety of higher dose intravenous anti-D immune globulin. Efficacy of Anti-D was measured in terms of rate of response and median time to response for increase in platelet counts. Any adverse event was noted. A decrease in haemoglobin concentration suggested accompanying haemolysis.

RESULTS: Seventy one out of 84 patients treated with Anti-D at 75μg/kg produced complete response (85%) with median time of response being 2.5 days. On the contrary, 45 patients (70%) patients treated with 50μg/kg had complete response. However, there was no significant increase in haemolysis with higher dose. A significant correlation was found between dose and peak increase in platelet count measured at 7

CONCLUSION: A 75μg/kg dose of Anti-D is more effective with acceptable side effect in comparison to 50μg dose for treatment of newly diagnosed Indian patients of ITP.

Keywords: Autoimmune; Children; Platelet count

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