Anti-RH immunoglobulin therapy for human immunodeficiency virus-related
immune thrombocytopenic purpura
E Oksenhendler, P Bierling, Y Brossard, C Schenmetzler, PM Girard, M Seligmann and JP Clauvel
Department of Immunohematology, Institut National de la Sante et de la
Recherche Medicale U108, Paris, France.
The potential hazards of steroids in human immunodeficiency virus (HIV)-
infected patients led us to evaluate the effectiveness and safety of anti-D
and anti-c Ig in 17 adults with severe HIV-related immune thrombocytopenic
purpura (platelet count less than 20 x 10(9)/L). The 14 Rh+ patients
received 12 to 25 micrograms/kg of anti-D IgG intravenously on two
consecutive days. A significant platelet rise above 50 x 10(9)/L was
obtained in nine patients. Repeated boosters were performed in six cases
and were effective in all cases. The 3 Rh- patients had a good response
after they were given 20 mL x 2 of plasma containing potent anti-c
antibodies. Therapy was well tolerated, and only one patient had
significant hemolysis. These data suggest that anti-Rh IgG can be effective
and safe in HIV-related thrombocytopenic purpura and that a specific
interaction between the RBC antigens and the anti-Rh antibodies is
required.
Volume 71,
Issue 5,
pp. 1499-1502,
05/01/1988
Copyright © 1988 by The American Society of Hematology
