Intravenous anti-D immunoglobulin in the treatment of resistant immune thrombocytopenic purpura in pregnancy

Authors

  • K Sieunarine,

    1. a Department of Obstetrics and Gynaecology and b Department of Haematology, West Middlesex University Hospital, Middlesex, UK
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  • a S Shapiro,

    1. a Department of Obstetrics and Gynaecology and b Department of Haematology, West Middlesex University Hospital, Middlesex, UK
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  • b MJ Al Obaidi,

    1. a Department of Obstetrics and Gynaecology and b Department of Haematology, West Middlesex University Hospital, Middlesex, UK
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  • and b J Girling a

    Corresponding author
    1. a Department of Obstetrics and Gynaecology and b Department of Haematology, West Middlesex University Hospital, Middlesex, UK
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J Girling, Department of Obstetrics and Gynaecology, West Middlesex University Hospital, Twickenham Road, Isleworth, Middlesex, TW7 6AF, UK. Email joanna.girling@wmuh.nhs.uk

Abstract

A 35-week pregnant 38-year-old woman presented with isolated thrombocytopenia (platelet count 4 × 109/l). Investigations confirmed immune thrombocytopenic purpura, and she received treatment with prednisolone and intravenous immunoglobulins with no increment in the platelet count. At 37 and 38 weeks of the pregnancy, she received two doses of WinRho (anti-D immunoglobulin) at 50 μg/kg. Five days later, with a platelet count of 46 × 109/l, she had an uncomplicated normal vaginal delivery. WinRho is a useful adjunct to other first-line treatment modalities for immune thrombocytopenia in pregnancy.

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