Acute renal failure after intravenous anti-D immune globulin in an adult with immune thrombocytopenic purpura.

Abstract:

:Intravenous anti-D immune globulin (anti-D IGIV) is indicated for the treatment of immune thrombocytopenic purpura (ITP) in nonsplenectomized patients who are Rh(D)-positive. Recent reports have described episodes of intravascular hemolysis (IVH) and acute renal failure (ARF) after anti-D IGIV. We report the first adult patient with ITP who required and received dialysis after IVH and ARF complicating treatment with anti-D IGIV. Whether the transfusion of 2 units of Rh(D)-positive red cells, indicated for the resulting anemia, exacerbated the IVH and renal failure is unclear. Three weeks after the administration of anti-D IGIV (13 days after two hemodialysis treatments), the patient's renal function had returned to normal. This case highlights the infrequent but potentially serious side effects of anti-D IGIV and the need to monitor a patient's renal function closely if there is evidence of IVH after infusion of anti-D IGIV. If red cell transfusion is indicated, we recommend the use of Rh(D)-negative red cell products.

journal_name

Am J Hematol

authors

Chun NS,Savani B,Seder RH,Taplin ME

doi

10.1002/ajh.10432

keywords:

subject

Has Abstract

pub_date

2003-12-01 00:00:00

pages

276-9

issue

4

eissn

0361-8609

issn

1096-8652

journal_volume

74

pub_type

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