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

S. H. Chen, D. C. Liang, M. Lin

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7 Citations (Scopus)

Abstract

A 9-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-temporo-occipital cerebral hematoma and a subarachnoid hemorrhage subsequently occurred. Intravenous immunoglobulin (IVIG) (Green Cross, Taiwan) at a dose of 0.4 g/kg/day for 5 days, followed by another 3 doses during the following 5 days, and combined with large-dose 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. IVIG (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 IVIG 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.

Original languageEnglish
Pages (from-to)165-166
Number of pages2
JournalAmerican Journal of Hematology
Volume49
Issue number2
DOIs
Publication statusPublished - 1995
Externally publishedYes

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Keywords

  • Aplastic anemia
  • Intracranial hemorrhage
  • IVIG
  • Platelet alloimmunization

ASJC Scopus subject areas

  • Hematology

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