Efficacy of Intravenous Immunoglobulin (IVIg) in Complicated Refractory Immune Thrombocytopenia Associated Systemic Lupus Erythematosus and Chronic Idiopathic Thrombocytopenic Purpura: Report of 6 Cases & Review Literatures
Keywords:
Immune thrombocytopenia, Intravenous immunoglobulinAbstract
Abstract: Objectives: To evaluate both short-term (< 90 days) and long-tern (2 90 days) results of intravenous immunoglobulin for adult complicated reffactory immune thrombocytopenia associated systemic lupus erythematosus and chronic idiopathic thrombocytopenic purpura. Design: Retrospective descriptive study. Patients and Methods: The study was performed in 6 adult patients with complicated reffactory immune thrombocytopenia associated systemic lupus erythematosus and chronic idiopathic thrombocytopenic purpura who failed to treatment with corticosteroids, immunosuppressive drugs and splenectomy. Two patients encountered intracerebral hemorhage, 2 patients underwent laminectony and 2 patients had severe mucocutaneous bleeding. We evaluate the initial response rate, the first day of platelet counts above 100x10 I, the day of maximum response, the duration of intial complete response and the long-term remission (platelet count 2 100x10/L at least 90 days) in these patients. Results: The initial response rate was 100 percent. After IVIg infusion, 5 of 6 patients platet counts increased significantly above 100010/L within 6 days. The day of maxumum response ranged from the 3 to 15 days. The duration of initial complete response in all patients was at least 13 days. The 3-year remission, 1-year remission and short-term remission (platelet count 04 100x107072 less than 90 days) in 5 evaluated patients were observed in 2 cases (40 percent), 1 case(20 percent) and 2 cases (40 percent), respectively. The febrile complication of IVIg was occurred in 2 patients. Conclusion: 1V/g produces promisingly rapid nomalization of platelet count in adult complicated refractory immune thrombocytopenia and is useful only in emergency cases who need immediate major operation or have severe bleeding.
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