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Blood, 1 September 2005, Vol. 106, No. 5, pp. 1532-1537. Prepublished online as a Blood First Edition Paper on May 5, 2005; DOI 10.1182/blood-2004-11-4303. This Article Full Text (PDF) All Versions of this Article: 2004-11-4303v1 106/5/1532    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Gaines, A. R Search for Related Content PubMed PubMed Citation Articles by Gaines, A. R Related Collections Related Articles in Blood Online Related Letter in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted November 12, 2004 Accepted April 26, 2005 Disseminated intravascular coagulation associated with acute hemoglobinemia and/or hemoglobinuria following Rho(D) immune globulin intravenous administration for immune thrombocytopenic purpura Ann R Gaines* Division of Biostatistics and Epidemiology (HFM-220), Center for Biologics Evaluation and Research, Food and Drug Administration, Rockville, MD, USA * Corresponding author; email: gaines{at}cber.fda.gov. The Food and Drug Administration (FDA) licensed Rho(D) immune globulin intravenous (anti-D IGIV) on March 24, 1995 for treatment of immune thrombocytopenic purpura (ITP). A previous review described 15 patients who experienced acute hemoglobinemia and/or hemoglobinuria following anti-D IGIV administration for ITP or secondary thrombocytopenia. Eleven of those patients also experienced clinically compromising anemia, transfusion with packed red blood cells, renal insufficiency, dialysis, and/or death. That review suggested that patients receiving anti-D IGIV be monitored for those and other potential complications of hemoglobinemia, particularly disseminated intravascular coagulation (DIC). Through November 30, 2004, FDA received 6 reports of DIC associated with "acute hemolysis" (or similar terms), 5 of which involved fatalities. The attending or consulting physicians assessed that acute hemolysis and/or DIC caused or contributed to each death. This review presents the first case series of DIC associated with acute hemoglobinemia and/or hemoglobinuria following anti-D IGIV administration. The purpose of this review is to increase awareness among physicians and other health care professionals that DIC may be a rare but potentially severe complication of anti-D IGIV treatment. Increased awareness of DIC as a diagnostic possibility may enable prompt recognition and medical intervention in affected patients. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Articles in Blood Online: A closer look at intravascular hemolysis (IVH) following intravenous anti-D for immune thrombocytopenic purpura (ITP) Michael D. Tarantino, James B. Bussel, Douglas B. Cines, Keith R. McCrae, Terry Gernsheimer, Howard A. Liebman, Wing-Yen Wong, Roshni Kulkarni, Eric Grabowski, and Robert McMillan Blood 2007 109: 5527. [Full Text] [PDF] Response: Further examination of intravascular hemolysis (IVH) following intravenous anti-D for immune thrombocytopenic purpura (ITP) Ann Reed Gaines Blood 2007 109: 5528. [Full Text] [PDF] Anti-D immune globulin: protecting platelets at a cost Alan R. Cohen Blood 2005 106: 1510. [Full Text] [PDF] Related Letter in Blood Online: Severe hemolysis following administration of Rho(D) immune globulin in an ITP patient associated with anti-C Joseph Schwartz, Steve Spitalnik, and Kathleen M. Grima Blood 2006 107: 2585. [Full Text] [PDF] This article has been cited by other articles: C. E. Neunert, G. R. Buchanan, P. Imbach, P. H. B. Bolton-Maggs, C. M. Bennett, E. J. Neufeld, S. K. Vesely, L. Adix, V. S. Blanchette, T. Kuhne, et al. Severe hemorrhage in children with newly diagnosed immune thrombocytopenic purpura Blood, November 15, 2008; 112(10): 4003 - 4008. [Abstract] [Full Text] [PDF] M. D. Tarantino, J. B. Bussel, D. B. Cines, K. R. McCrae, T. Gernsheimer, H. A. Liebman, W.-Y. Wong, R. Kulkarni, E. Grabowski, and R. McMillan A closer look at intravascular hemolysis (IVH) following intravenous anti-D for immune thrombocytopenic purpura (ITP) Blood, June 15, 2007; 109(12): 5527 - 5527. [Full Text] [PDF] A. R. Gaines Response: Further examination of intravascular hemolysis (IVH) following intravenous anti-D for immune thrombocytopenic purpura (ITP) Blood, June 15, 2007; 109(12): 5528 - 5528. [Full Text] [PDF] D. A. Schirmer, S.-C. Song, J. P. Baliff, S. O. Harbers, R. A. Clynes, A. Krop-Watorek, G. R. Halverson, M. Czerwinski, and S. L. Spitalnik Mouse models of IgG- and IgM-mediated hemolysis Blood, April 1, 2007; 109(7): 3099 - 3107. [Abstract] [Full Text] [PDF] R. Deng and J. P. Balthasar Comparison of the effects of antibody-coated liposomes, IVIG, and anti-RBC immunotherapy in a murine model of passive chronic immune thrombocytopenia Blood, March 15, 2007; 109(6): 2470 - 2476. [Abstract] [Full Text] [PDF] J. Schwartz, S. Spitalnik, and K. M. Grima Severe hemolysis following administration of Rho(D) immune globulin in an ITP patient associated with anti-C. Blood, March 15, 2006; 107(6): 2585 - 2585. [Full Text] [PDF] C. Kendall and E. Wooltorton WinRho and disseminated intravascular coagulopathy Can. Med. Assoc. J., March 14, 2006; 174(6): 767 - 768. [Full Text] [PDF] D. B. Cines and J. B. Bussel How I treat idiopathic thrombocytopenic purpura (ITP) Blood, October 1, 2005; 106(7): 2244 - 2251. [Full Text] [PDF]

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