Rewald MDE, Francischetti MM. After eight-year-tolerance minimal i.v. anti-D infusions unleash hemolysis in a patient with immune thrombocytopenic purpura (ITP).
Transfus Apher Sci 2004;
30:105-10. [PMID:
15062747 DOI:
10.1016/j.transci.2003.09.001]
[Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2003] [Accepted: 09/03/2003] [Indexed: 11/24/2022]
Abstract
Minimal doses of i.v. anti-D for ITP are not exempt from the risk of intravascular hemolysis, a rare potentially severe short-lived post-infusion complication. We report here on an elderly woman with chronic pancytopenia and splenomegaly in whom bleeding manifestations ceased after i.v. anti-Rh(D) immunoglobulin minidoses replaced long-term conventional treatment for immune thrombocytopenic purpura. Anti-Rh(D) infusions, that had been well tolerated for eight years, became the main culprit in triggering of disproportionate hemolysis. In spite of in crescendo complication, the anti-Rh(D) immunoglobulin schedule was maintained for another six months. With no further treatment, the patient's health remains stable 20 months later.
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