Abstract

Aim: Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disease characterized by thrombocytopenia because of acceleration in platelet destruction, presence of antiplatelet antibody in the plasma, increased megakaryocytes in the bone marrow. ITP treatment depends on individual basis and degree of thrombocytopenia. Anti-D is a gamma globulin (Ig G) fraction containing a high proportion of antibodies against Rho (D) antigen of the red blood cells. Nowadays clinical studies have shown that intravenous anti-D is a safe and an effective treatment for Rh positive nonsplenectomized patients with ITP. The aim of t his study was to evaluate the efficacy and reliahility of intravenous anti-Rho (D) treatment in acute and chronic ITP of children. Methods: Fifteen pediatric patients with chronic and acute ITP aged between 2-15 years who were followed-up at izmir Dr. Behçet Uz Children's Hospital Hematology Department were included in the study. Patients were treated by 50 ug/kg/dose anti-D (WinRh oSDFTM). The platelet counts and hemoglobin levels were detected before and after treatment on the first, 3rd and 7th days. Platelet counts > 150x10L on the 7th day "complete response" 20-150xl09/L "partial response" and platelet counts <20x109/L were accepted as "no pesponse". Patients were followed for 1-53 weeks after therapy. For statistical analysis Fisher-exact test was used. Results^ Partial and complete responses were observed in 9 and 3 patients respeetively. Median platelet count of ali the patients on the 7th day was 79x109/L and the platelet counts of the patients continued to be over 20x109/L for median 3 weeks (0-52 weeks). No statistical differ ence was found between the chronic and acute ITP patients in terms of response to anti-D therapy. Mean Hb decelleration of 1.2 ± 1.0 gr/dl was observed after therapy within the whole patients and only one patient had to be transfused because of the gastrointestinal bleeding. No serious side effects were seen. Conclusion: Anti-D is a safe, convenient, inexpensive and effective therapy for childhood ITP.