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Inefficacy of intravenous immunoglobulin in patients with low‐risk thrombotic thrombocytopenic purpura/hemolytic‐uremic syndrome
Author(s) -
Finazzi Guido,
Bellavita Piero,
Falanga Anna,
Viero Piera,
Barbui Tiziano
Publication year - 1992
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.2830410305
Subject(s) - medicine , thrombotic thrombocytopenic purpura , hematology , gastroenterology , prospective cohort study , antibody , hemolytic anemia , pediatrics , platelet , immunology
Objective: To assess the efficacy of intravenous immunoglobulin (IVIG), in comparison with plasma exchange (PE), in the treatment of patients with thrombotic thrombocytopenic purpura/hemolytic‐uremic syndrome (TTP/HUS). © 1992 Wiley‐Liss, Inc. Design: Prospective, nonrandomized comparative study. Setting: Hematology department in a general hospital. Patients: 17 consecutive adult patients, six of them pregnant, with diagnosis of TTP/ HUS. Three had a severity score at diagnosis ≦4 and were treated with IVIG and 14 had a severity score of ≧5 and/or were pregnant and received PE. The response was evaluated after 5 days of therapy. Results: Complete remission was obtained in 0/3 cases treated with IVIG and 10/14 (71%) with PE (Fisher's exact test P = 0.05). Three patients died for widespread TTP‐HUS, and four had persistent disease. In three of the four resistant patients, complete remission was obtained by further PE but not by further IVIG. The overall remission rate was 76% (13/17). Conclusions: Our study does not confirm the utility of IVIG in the management of TTP‐HUS, as suggested by earlier single case reports. © 1992 Wiley‐Liss, Inc.