PT  - JOURNAL ARTICLE
AU  - Williams, Kristina
TI  - Use of Intravenous Anti-RhD Immunoglobulin (RhIG) in the Treatment of Primary Immune Thrombocytopenia
AID  - 10.29074/ascls.29.2.92
DP  - 2016 Apr 01
TA  - American Society for Clinical Laboratory Science
PG  - 92--97
VI  - 29
IP  - 2
4099  - http://hwmaint.clsjournal.ascls.org/content/29/2/92.short
4100  - http://hwmaint.clsjournal.ascls.org/content/29/2/92.full
SO  - Clin Lab Sci2016 Apr 01; 29
AB  - Commercialized intravenous immunoglobulin (IVIG) products have been used since the early 1980s for various patient treatment options, specifically to induce an immunomodulatory and therapeutic effect. IVIG, a pooled immunoglobulin G (IgG) preparation, is used for patients with immune deficiencies, inflammatory conditions, and autoimmune disorders such as primary immune thrombocytopenia (ITP). Front-line therapies for ITP include corticosteroids, IVIG, or anti-RhD immune globulin (RhIG). WinRho SDF (Cangene Corporation, Winnipeg, Manitoba, Canada), a RhIG preparation, was FDA-approved for use in 2005 and is used for treatment of patients with ITP through what is called a Fc blockade mechanism. After intravenous WinRho administration, patient platelets are spared from clearance by the spleen and with a good response to treatment, the patient's platelet count increases. WinRho is not without potential side effects and also impacts the transfusion service pre-transfusion testing in the event that the patient undergoing treatment requires red cell transfusion. In 2010, a work group of experts reviewed the warnings associated with RhIG and concluded that assuming that patients are appropriate candidates for RhIG, monitored in a clinical setting for 8 hours after administration, RhIG products such as WinRho are considered a very effective front-line therapy for ITP.1 Effective first line therapies can circumvent the necessity for less-desirable second line therapies such as an invasive splenectomy or life-long treatment with thrombopoietin-receptor agonists (TPO-RAs) to increase platelet counts.ABBREVIATIONS: IVIG – intravenous immunoglobulin, ITP – primary immune thrombocytopenia, RhIG – Rh immune globulin, TPO-RAs – thrombopoietin-receptor agonists, MPV – mean platelet volume, RBC – red blood cell, HUS – hemolytic uremic syndrome, TTP – thrombotic thrombocytopenic purpura, DIC – disseminated intravascular coagulation, CBC – complete blood count, PT – prothrombin time, APTT – activated partial thromboplastin time, FDA – Food and Drug Administration