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The Effect of Intravenous Gammaglobulin for Acute Idiopathic Thrombocytopenic Purpura in Children.

Journal of the Korean Pediatric Society 1985;28(5):483-491.
Published online May 31, 1985.
The Effect of Intravenous Gammaglobulin for Acute Idiopathic Thrombocytopenic Purpura in Children.
Seung In Baek, Geum Joo Kim, Kuhn Soo Lee, Sang Bum Lee, Doo Hong Ahn
Department of Pediatrics, School of Medicine, Kyungpook National University,Taegu, Korea
소아 급성 특발성 혈소판감소성 자반증(ITP)에 있어서 정주용 감마글로부린의 효과
백승인, 김금주, 이건수, 이상범, 안두홍
경북대학교 의과대학 소아과학교실
Abstract
A clinical study was conducted to determined the effectiveness of intravenous gammaglobulin on childhood acute ITP. Study group consisted of 8 children who were treated with IV Globulin(0.4 gm/kg/d, 5 days) only or combined with steroid, and control group of 19 children who were treated with steroid only. Study period was from January 1980 to June 1984, and following results were obtained. There was no difference in clinical symptoms and laboratory findings between control and study group. One to five years of age group was involved most frequently (44.5%), age group less than 1 year of age was 29.6%, and male to female ratio was 1 : 1.5. Previous URI history was noted in 51.8% and most of them (71.5%) within the first 2 weeks. Clinical symptoms in order of frequency were petechiae or bruise(100%), epistaxis(55.6%), gingival bleeding(18.5%), hematuria (14.8%), hepatomegaly (11.1%), and splenomegaly (11.1%). The platelet count below 50,000/mm3 was noted in 77.8% and severe thrombocytopenia (<20,000/mm3) in 29.6%. All the patients with hematuria showed platelet counts less than 50,000/mm3. The tourniquet test was positive in 62.5% and bleeding time was prolonged in 58.8%. Concomitant or associated illnesses were anemia in 40.7%, SLE in 3.7%, bronchial asthma in 3.7%f lymphadenitis due to BCG injection in 3.7%, and giant urticaria in 3.7%. In the study group, time required for platelet count rising over 50,000/mm3, 100,000/mm3, and 150,000/mm3 was more shorter than the control group and it was statistically significant. During the follow-up periods, rate of relapse was more frequent in the study group than the control, and was statistically significant at 90th day.
Key Words: ITP, Intravenous gammaglobulin, Purpura, Steroid


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