Comparison of intravenous immunoglobulin and high dose anti-D immunoglobulin as initial therapy for childhood immune thrombocytopenic purpura: response Ozsoylu.

摘要

We thank Dr. Ozsoylu for his comments on our article describing the comparison of intravenous immune globulin (IVIG) and high dose anti-D immune globulin in the management of childhood immune thrombocytopenic pur-pura (ITP) (Kane et al, 2010). We would like to emphasize that our study was not designed to include a control group (consisting of no treatment) or a methylprednisone group. While controversial (particularly in the UK, where watchful waiting is an accepted option), the standard of care at our institution in the United States has been to treat ITP with IVIG or anti-D to quickly reverse severe thrombocytopenia. Although most cases of ITP will resolve without treatment, it is thought that increasing the platelet count decreases the risk (however remote) of intracranial haemorrhage. We do not dispute that steroids are a viable treatment option for ITP, particularly when the cost of treatment is considered.. Multiple studies have established the feasibility of steroids as a treatment for ITP (Ozsoylu & Erturk, 1991; Blanchette et al, 1994).