Treatment of platelet alloimmunization with intravenous immunoglobulin in a child with aplastic anemia

✍ Scribed by Dr. Shu-Huey Chen; Der-Cherng Liang; Marie Lin

• Publisher: John Wiley and Sons
• Year: 1995
• Tongue: English
• Weight: 221 KB
• Volume: 49
• Category: Article
• ISSN: 0361-8609
• DOI: 10.1002/ajh.2830490213

✦ Synopsis

A %year-old girl with severe refractory aplastic anemia had become refractory to platelet transfusion due to platelet alloimmunization. As a result, a huge right parieto-temporooccipital cerebral hematoma and a subarachnoid hemorrhage subsequently occurred. Intravenous immunoglobulin (IVIG) (Green Cross, Taiwan) at a dose of 0.4 glkglday for 5 days, followed by another 3 doses during the following 5 days, and combined with largedose platelet transfusions effectively controlled the bleeding by elevating the platelet count to above 100 x 103/mm3. The patient soon recovered with only a mild sequela. Two months later, because of multiple caries and a periodontal abscess, dental extraction needed to be performed. WIG (0.4 g/kg/day x 6 days) enabled surgery to proceed by elevating the platelet count to above 55 x 103/mm3, and no bleeding complications occurred during or after the procedure. The potential benefit of high-dose WIG in modulating platelet alloimmunization is a result of increasing the survival of transfused platelets. Thus, this therapy is recommended when patients with platelet alloimmunization have critical bleeding episodes or undergo surgical procedures.