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Keywords:

  • ITP;
  • platelets;
  • anaemia;
  • Rho (D);
  • i.v. gammaglobulin

Treatment with 75 μg/kg/d intravenous (i.v.) anti-D was compared with 50 μg/kg/d in a prospective randomized study of 27 RhD-positive, human immunodeficiency virus-negative, adult, acute, non-splenectomized patients with immune thrombocytopenic purpura (ITP) and platelet counts ≤ 30 × 109/l. The higher dose resulted in greater median d 1 (43 × 109/l vs. 7·5 × 109/l; P = 0·012) and d 7 (153 × 109/l vs. 64·5 × 109/l; P = 0·001) platelet increases despite no greater haemoglobin decrease. Children with acute ITP receiving 75 μg/kg/d had overnight platelet increases in seven out of nine cases. The duration of effect at the 75 μg/kg/d dose was 46 d vs. 21 d (P = 0·03). Adverse events were mild to moderate and ameliorated with prednisone and acetaminophen premedication.