Thrombocytopenia associated with dengue hemorrhagic fever responds to intravenous administration of anti-D (RH0-D) immune globulin

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American Journal of Tropical Medicine and Hygiene


Severe thrombocytopenia and increased vascular permeability are two major characteristics of dengue hemorrhagic fever (DHF). An immune mechanism of thrombocytopenia due to increased platelet destruction appears to be operative in patients with DHF (see Saito et al., 2004, Clin Exp Immunol 138: 299-303; Mitrakul, 1979, Am J Trop Med Hyg 26: 975-984; and Boonpucknavig, 1979, Am J Trop Med Hyg 28: 881-884). The interim data of two randomized placebo controlled trials in patients (N = 47) meeting WHO criteria for dengue hemorrhagic fever (DHF) with severe thrombocytopenia (platelets ≤ 50,000/mm3) reveal that the increase in platelet count with anti-D immune globulin (WinRho® SDF), 50 μg/kg (250 IU/kg) intravenously is more brisk than the placebo group. The mean maximum platelet count of the anti-D-treated group at 48 hours was 91,500/mm3 compared with 69,333/mm3 in the placebo group. 75% of the anti-D-treated group demonstrated an increase of platelet counts ≥ 20,000 compared with only 58% in the placebo group. These data suggest that treatment of severe thrombocytopenia accompanying DHF with anti-D may be a useful and safe therapeutic option. Copyright © 2007 by The American Society of Tropical Medicine and Hygiene.

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