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Failure of high‐dose I.V. Gammaglobulin in the treatment of spontaneously acquired factor VIII inhibitors
Author(s) -
Heyman Meyer R.,
Chakravarthy Anuradha,
Edelman Bennett B.,
Needleman Samuel W.,
Schiffer Charles A.
Publication year - 1988
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.2830280313
Subject(s) - gamma globulin , medicine , titer , gastroenterology , immunology , antibody
Two patients with spontaneously acquired factor‐VIII‐CC inhibitors were treated with highdose i.v. gammaglobulin. Minimal inhibfiion of anti‐VIII‐CC activity was demonstrated in vitro in one patient when i.v. gammaglobulin was mixed directly with his plasma. In neither patient, however, was there any signficant reduction in titer of antifactor VIII‐C after i.v. gammaglobulin administration, nor was there any shortening of the aPTT or reduction in bleeding. The possible mechanisms of the previously reported salutary benefits of high‐dose i.v. gammaglobulin in patients with spontaneously acquired factor‐VIII inhibitors as well as the potential reasons for failure in our patients are discussed. Our cases demonstrated that high‐dose i.v. gammaglobulin is not uniformly successful in the treatment of patients with acquired factor‐VIII‐C inhibitors. The true frequency of clinically signficant responses will require further clinical trials.