Subcutaneous Anti-D versus intravenous methylprednisolone for the treatment of immune thrombocytopenic purpura

Authors

  • Olia Sharmeen Department of Paediatric Haematology and Oncology, Department of Paediatrics, Sir Salimullah Medical College, Dhaka, Bangladesh
  • Mohammod Hasanur Rashid Department of Respiratory Medicine, National Institute of The Diseases of The Chest and Hospital, Dhaka, Bangladesh
  • Md Abdur Rouf Department of Paediatrics, Sir Salimullah Medical College, Dhaka, Bangladesh
  • Afiqul Islam Department of Paediatric Haematology and Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh

DOI:

https://doi.org/10.18203/2349-3291.ijcp20183505

Keywords:

Anti-D immunoglobulin, High dose intravenous methylprednisolone, Idiopathic thrombocytopenic purpura

Abstract

Background: Established treatment option for immune thrombocytopenic purpura (ITP) are intravenous immunoglobulin (IVIg), anti-D immunoglobulin’ and high dose intravenous methyl prednisolone (HIVMP). The present study was undertaken to compare the efficacy of subcutaneous bolus anti-D over HIVMP in the treatment of ITP.

Methods: A randomized clinical trial was conducted on a total 20 children with ITP, presented with extensive bleeding manifestation and platelet count <20 × 109/L;10 children received single dose subcutaneous anti-D (75 microgram/kg) and 10 children received HIVMP (30 mg/kg/dose) for 3 consecutive days. Patients were monitored for response to treatment and adverse events, platelet count and hemoglobin label were done in all patients at 24-hour, 48-hour, 72 hour, 1st week, 2nd week, 1st month, 2nd month and 3rd month after treatment to observe the change. Response rate define as a platelet count over 20 × 109/L within 72 hours of treatment. All the data were analyzed with the help of SPSS software version 16.0.

Results: By 24 hours of treatment 40% patient of anti-D and 10% patients of HIVMP group had platelet count >20 x109/L, by 72 hours 90% patients of both group achieved complete response (P =1.750). In HIVMP group the rate of remission gradually decreasing but in anti-D group it was persistently remain high. In anti-D group hemoglobin concentration decreased in 80% cases (P=0.023) but rate of decrease was not significant. New hemorrhage or significant extension of hemorrhage did not observe in any group.

Conclusions: A single dose of subcutaneous anti-D raised platelet count in children with ITP more rapidly and effectively than HIVMP (30 mg/kg/dose) with an acceptable safety profile.

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References

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Published

2018-08-24

How to Cite

Sharmeen, O., Rashid, M. H., Rouf, M. A., & Islam, A. (2018). Subcutaneous Anti-D versus intravenous methylprednisolone for the treatment of immune thrombocytopenic purpura. International Journal of Contemporary Pediatrics, 5(5), 1719–1723. https://doi.org/10.18203/2349-3291.ijcp20183505

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Original Research Articles