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Acute renal failure after intravenous anti‐D immune globulin in an adult with immune thrombocytopenic purpura
Author(s) -
Chun Nancy S.,
Savani Bipin,
Seder Richard H.,
Taplin Mary Ellen
Publication year - 2003
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.10432
Subject(s) - medicine , thrombocytopenic purpura , dialysis , immune system , hemodialysis , purpura (gastropod) , gastroenterology , anemia , platelet , renal function , thrombotic thrombocytopenic purpura , immunology , ecology , biology
Intravenous anti‐D immune globulin (anti‐D IGIV) is indicated for the treatment of immune thrombocytopenic purpura (ITP) in nonsplenectomized patients who are Rh(D)‐positive. Recent reports have described episodes of intravascular hemolysis (IVH) and acute renal failure (ARF) after anti‐D IGIV. We report the first adult patient with ITP who required and received dialysis after IVH and ARF complicating treatment with anti‐D IGIV. Whether the transfusion of 2 units of Rh(D)‐positive red cells, indicated for the resulting anemia, exacerbated the IVH and renal failure is unclear. Three weeks after the administration of anti‐D IGIV (13 days after two hemodialysis treatments), the patient's renal function had returned to normal. This case highlights the infrequent but potentially serious side effects of anti‐D IGIV and the need to monitor a patient's renal function closely if there is evidence of IVH after infusion of anti‐D IGIV. If red cell transfusion is indicated, we recommend the use of Rh(D)‐negative red cell products. Am. J. Hematol. 74:276–279, 2003. © 2003 Wiley‐Liss, Inc.