Publication:

Subcutaneous Anti-D versus intravenous methylprednisolone for the treatment of immune thrombocytopenic purpura

Background Established treatment option for immune thrombocytopenic purpura (ITP) are intravenous immunoglobulin (IVIg), anti-D immunoglobulin’ and high dose intravenous methyl prednisolone (HIVMP). The present study was undertaken to compare the efficacy of subcutaneous bolus anti-D over HIVMP in the treatment of ITP.

Methods A randomized clinical trial was conducted on a total 20 children with ITP, presented with extensive bleeding manifestation and platelet count 20 x109/L, by 72 hours 90% patients of both group achieved complete response (P =1.750). In HIVMP group the rate of remission gradually decreasing but in anti-D group it was persistently remain high. In anti-D group hemoglobin concentration decreased in 80% cases (P=0.023) but rate of decrease was not significant. New hemorrhage or significant extension of hemorrhage did not observe in any group.

Conclusions A single dose of subcutaneous anti-D raised platelet count in children with ITP more rapidly and effectively than HIVMP (30 mg/kg/dose) with an acceptable safety profile.