All issues > Volume 28(5); 1985

Original Article

J Korean Pediatr Soc. 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

¹Department of Pediatrics, School of Medicine, Kyungpook National University,Taegu, Korea

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.

Keywords :ITP; Intravenous gammaglobulin; Purpura; Steroid