Online citations, reference lists, and bibliographies.
← Back to Search

Safety And Efficacy Of Low‐Dose Intravenous Immune Globulin (IVIG) Treatment For Infants And Children With Immune Thrombocytopenic Purpura

I. Warrier, J. Bussel, L. Valdez, J. Barbosa, D. Beardsley
Published 1997 · Medicine

Save to my Library
Download PDF
Analyze on Scholarcy Visualize in Litmaps
Share
Reduce the time it takes to create your bibliography by a factor of 10 by using the world’s favourite reference manager
Time to take this seriously.
Get Citationsy
Purpose: This report presents pooled data from two multicenter studies conducted to assess the efficacy, safety, and tolerance of lower-dose intravenous immune globulin (IVIG) regimens of 250 mg/kg/day, 400 mg/kg/day, and 500 mg/kg/day for 2 days, compared to an established higher-dose regimen of 1 g/kg/day for 2 days, in children with immune thrombocytopenic purpura (ITP). Patients and Methods: A total of 24 children received IVIG (Gammar Sr I.V.). In Study 1, 10 centers enrolled 12 children between 5 and 12 years old who received IVIG at either 400 mg/kg/day or 1 g/kg/day for 2 days. In Study 2, five centers enrolled 12 infants and children younger than 5 years old who received IVIG at 250 mg/kg/day or 500 mg/kg/day for 2 days. Both studies were prospective and randomized. Results: IVIG treatment was effective (platelets increased at least 30,000/cu mm over baseline) in 94% (16 of 17) of the evaluable patients in the low-dosage group. Platelet increases occurred rapidly: by 48 hours, total platelet counts ranged from 32,000/cu mm to 256,000/cu mm, and peak platelet counts reached 38,000/cu mm to 551,000/cu mm. Adverse events (AEs) were most often mild, lasted less than 3 hours, and were usually those typically associated with immunoglobulin administration-headache, nausea, vomiting, and fever. There were two serious AEs—an anaphylactoid reaction in one patient in the 400 mg/kg group and aseptic meningitis in one patient in the 1 g/kg high-dosage group. Both patients recovered without sequelae and were responders. Although the incidence of AEs varied by dosage groups, this difference was not significant. However, the incidence of AEs was affected by age. AEs were significantly lower in patients younger than 5 years of age. Conclusions: In this small, randomized trial, low-dose IVIG in 2-day regimens of 250, 400, or 500 mg/kg/day rapidly reversed thrombocytopenia just as effectively as 1 g/kg/day in infants and young children with ITP. Lower-dosage regimens are safe and well-tolerated; the incidence of AEs is lower in children younger than 5 years of age.
This paper references
10.1016/s0140-6736(75)90887-9
Letter: Splenectomy and lymphomas.
Stephens Rl (1975)
10.1016/S0140-6736(83)91738-5
HIGH-DOSE INTRAVENOUS IgG IN ADULTS WITH AUTOIMMUNE THROMBOCYTOPENIA
A. Newland (1983)
10.1182/BLOOD.V62.2.480.BLOODJOURNAL622480
Intravenous gammaglobulin treatment of chronic idiopathic thrombocytopenic purpura
J. Bussel (1983)
10.1016/S0022-3476(83)80608-8
Intravenous use of gammaglobulin in the treatment of chronic immune thrombocytopenic purpura as a means to defer splenectomy.
J. Bussel (1983)
10.1136/adc.58.11.851
Chronic idiopathic thrombocytopenia treated with immunoglobulin.
P. Mori (1983)
10.1016/0002-9343(84)90339-5
Intravenous immunoglobulin administration in the treatment of severe chronic immune thrombocytopenic purpura.
R. Carroll (1984)
10.1016/S0022-3476(85)80231-6
Treatment of acute idiopathic thrombocytopenia of childhood with intravenous infusions of gammaglobulin.
J. Bussel (1985)
10.1016/S0140-6736(85)90400-3
INTRAVENOUS IMMUNOGLOBULIN VERSUS ORAL CORTICOSTEROIDS IN ACUTE IMMUNE THROMBOCYTOPENIC PURPURA IN CHILDHOOD
P. Imbach (1985)
Clinical uses of intravenous immune globulin.
M. J. Knapp (1990)
10.1016/S0022-3476(05)80400-7
A prospective, randomized trial of high-dose intravenous immune globulin G therapy, oral prednisone therapy, and no therapy in childhood acute immune thrombocytopenic purpura.
V. Blanchette (1993)
10.1016/S0140-6736(94)92205-5
Randomised trial of intravenous immunoglobulin G, intravenous anti-D, and oral prednisone in childhood acute immune thrombocytopenic purpura
V. Blanchette (1994)



This paper is referenced by
10.3109/08916934.2015.1104671
Different dosages of intravenous immunoglobulin (IVIg) in treating immune thrombocytopenia with long-term follow-up of three years: Results of a prospective study including 167 cases
Zeping Zhou (2016)
10.1016/j.msec.2014.10.007
Affinity composite cryogel discs functionalized with Reactive Red 120 and Green HE 4BD dye ligands: application on the separation of human immunoglobulin G subclasses.
S. Huseynli (2015)
10.1586/1744666X.2015.1079485
Different brands of intravenous immunoglobulin for primary immunodeficiencies: how to choose the best option for the patient?
H. Abolhassani (2015)
10.1002/emmm.201302857
Liver gene therapy by lentiviral vectors reverses anti-factor IX pre-existing immunity in haemophilic mice
A. Annoni (2013)
Early Prediction of Chronic Childhood Immune Thrombocytopenic Purpura According to the Response of Immunoglobulin Treatment
Uk Hyun Kim (2013)
10.1097/CND.0b013e3182212589
The Safety Profile of Home Infusion of Intravenous Immunoglobulin in Patients With Neuroimmunologic Disorders
N. Souayah (2011)
10.1097/MPH.0b013e3181bf29b6
Idiopathic Thrombocytopenic Purpura in a Boy With Ataxia Telangiectasia on Immunoglobulin Replacement Therapy
J. Heath (2010)
10.1016/J.BIOPHA.2010.09.013
WITHDRAWN: The efficacy of different dose of intravenous immunoglobulin in treating acute idiopathic thrombocytopenic purpura: A meta-analysis of 13 randomized control trials
Yuan-Han Qin (2010)
10.1097/MBC.0b013e3283401490
The efficacy of different dose intravenous immunoglobulin in treating acute idiopathic thrombocytopenic purpura: a meta-analysis of 13 randomized controlled trials
Yuanhan Qin (2010)
10.1159/000268855
Management of Chronic Childhood Immune Thrombocytopenic Purpura: AIEOP Consensus Guidelines
D. De Mattia (2009)
10.1365/S10337-009-1071-6
Adsorption Study of Immunoglobulin G Subclasses from Different Species by Pseudobioaffinity Separation on Histidyl–Bisoxirane–Sepharose
A. Elkak (2009)
10.5045/KJH.2009.44.1.28
The Effectiveness of High Dose Dexamethasone for the Initial Treatment of Childhood Acute Idiopathic Thrombocytopenic Purpura
J. S. Choi (2009)
10.1002/pbc.21231
How far should we go with cost‐utility analysis when treating children with acute idiopathic thrombocytopenic purpura?
M. Benesch (2008)
10.1007/s12098-008-0137-z
Immune thrombocytopenic purpura
V. Gupta (2008)
10.1007/s12098-008-0243-y
Intravenous immune globulin versus intravenous anti-D immune globulin for the treatment of acute immune thrombocytopenic purpura
E. Shahgholi (2008)
Supporting Informed Decisions Polyclonal Intravenous Immunoglobulin in Patients with Immune Thrombocytopenic Purpura : Clinical Systematic
Stella Chen (2008)
10.1097/MPH.0b013e31817541ba
A Single Dose of Anti-D Immunoglobulin Raises Platelet Count as Efficiently as Intravenous Immunoglobulin in Newly Diagnosed Immune Thrombocytopenic Purpura in Korean Children
D. W. Son (2008)
10.1016/J.TMRV.2007.01.001
Guidelines on the use of intravenous immune globulin for hematologic conditions.
D. Anderson (2007)
Acute immune thrombocytopenic purpura in children.
A. Rehman (2007)
10.1002/pbc.20830
A cost‐utility analysis of treatment for acute childhood idiopathic thrombocytopenic purpura (ITP)
Sarah H. O'Brien (2007)
Recent Advances in the Treatment of Childhood
M. Tarantino (2006)
10.1016/J.JPEDS.2005.11.019
Single dose of anti-D immune globulin at 75 microg/kg is as effective as intravenous immune globulin at rapidly raising the platelet count in newly diagnosed immune thrombocytopenic purpura in children.
M. Tarantino (2006)
10.1053/J.SEMINHEMATOL.2006.04.008
Recent advances in the treatment of childhood immune thrombocytopenic purpura.
M. Tarantino (2006)
10.1159/000089465
Randomized Trial of Anti-D Immunoglobulin versus Low-Dose Intravenous Immunoglobulin in the Treatment of Childhood Chronic Idiopathic Thrombocytopenic Purpura
Mohsen S El Alfy (2006)
10.1542/peds.2004-1324
Intravenously Administered Immunoglobulin in the Treatment of Childhood Guillain-Barré Syndrome: A Randomized Trial
R. Korinthenberg (2005)
10.1016/B978-012348776-6/50024-8
Chapter 21 – Transfusion of the Patient with Autoimmune Hemolysis
K. King (2004)
10.1007/s00112-004-0925-0
Immunthrombozytopenische Purpura bei Kindern
H. Gadner (2004)
10.1016/J.HOC.2004.07.003
The pros and cons of drug therapy for immune thrombocytopenic purpura in children.
M. Tarantino (2004)
10.1097/00043426-200310000-00011
Low-Dose Versus High-Dose Immunoglobulin for Primary Treatment of Acute Immune Thrombocytopenic Purpura in Children: Results of a Prospective, Randomized Single-Center Trial
M. Benesch (2003)
10.1046/j.1365-2141.2003.04131.x
Guidelines for the investigation and management of idiopathic thrombocytopenic purpura in adults, children and in pregnancy
D. Provan (2003)
10.1067/MEM.2002.124442
Immediate hypersensitivity reaction associated with the rapid infusion of Crotalidae polyvalent immune Fab (ovine).
C. Holstege (2002)
10.1097/00006565-200212000-00006
Aseptic meningitis due to administration of intravenous immunoglobulin with an unusually high number of leukocytes in cerebrospinal fluid
I. Obando (2002)
See more
Semantic Scholar Logo Some data provided by SemanticScholar