Summary
The correlation between the response to high-dose immunoglobulin therapy (IVIg) and the sequestration pattern of Indium-labeled platelets (In-PLT) in the body was studied in 9 patients with chronic idiopathic thrombocytopenic purpura (ITP). Patients that has prominent platelet sequestration in the spleen responded to IVIg. In these patients, splenic sequestration decreased by 20–30% after IVIg without significant changes in hepatic sequestration. This finding suggests that the blocking of splenic Fc receptors with immunoglobulin minimized the destruction of sensitized platelets. However, patients who had almost equal platelet sequestration in the liver and spleen did not respond to IVIg. In these patients, hepatic sequestration decreased after IVIg, whereas splenic sequestration increased. Thus, it appears that estimating the platelet sequestration pattern using In-PLT is useful for predicting the effects of IVIg.
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References
Abe T, Matsuda J (1981) A study of new enzyme immunoassay for quantification of platelet bound IgG and its clinical significance. In: Nydegger UE (eds) Immunohemotherapy. A guide to immunoglobulin prophylaxis and therapy. Academic Press, New York, pp 409–418
Abe T, Matsuda J, Kawasugi K, Yoshimura Y, Kinoshita T, Kazama M (1983) Clinical effect intravenous immunoglobulin on chronic idiopathic thrombocytopenic purpura. Blut 47: 69–75
Abe T, Matsuda J, Kawasugi K (1986) Functional effects of immunoglobulin on platelets. In: Morell A, Nydegger UE (eds) Clinical use of intravenous immunoglobulin. Academic Press, London, pp 187–202
Ballem PJ, Segal GM, Stratton JR, Gernsheimer T, Adamson JW, Slichter SJ (1987) Mechanisms of thrombocytopenia in chronic autoimmune thrombocytopenic purpura. J Clin Invest 80: 33–40
Branehog I, Kutti J, Weinfeld A (1974) Platelet survival and platelet production in idiopathic thrombocytopenic purpura (ITP). Br J Haematol 27: 127–143
Bussel JB, Pham LC (1987) Intravenous treatment with gammaglobulin in adults with immune thrombocytopenic purpura: Review of the literature. Vox Sang 52: 206–211
Bussel JB, Kimberly RP, Inman RD, Schulman I, Cunningham-Randles C, Cheung N, Smithwick EM, O'Malley J, Barandun S, Hilgartner WM (1983) Intravenous gammaglobulin treatment of chronic idiopathic thrombocytopenic purpura. Blood 62: 480–486
Bussel JB, Pham LC, Aledort L, Nachman R (1988) Maintenance treatment of adults with chronic refractory immune thrombocytopenic purpura using repeated intravenous infusion of gammaglobulin. Blood 72: 121–127
Carroll RR, Noyes WD, Rosse WF, Kitchens CS (1984) Intravenous immunoglobulin administration in the treatment of severe chronic immune thrombocytopenic purpura. Am J Med 76: 181–186
Clarkson SB, Bussel JB, Kimberly RP, Valinsky JE, Nachman RL, Unkeless JC (1986) Treatment of refractory immune thrombocytopenic purpura with an Anti-Fcy-Receptor antibody. New Engl J Med 314: 1236–1322
Dewanjee MK, Shyam AR, Didisheim P (1981) Indium-111 tropolone, A new high-affinity platelet label: Preparation and evaluation of labeling parameters. J Nucl Med 22: 981–987
Fehr J, Hofmann V, Kappeler U (1982) Transient reversal of thrombocytopenia in idiopathic thrombocytopenic purpura by high-dose intravenous gamma globulin. New Engl J Med 306: 1254–1258
Harker LA (1970) Thrombokinetics in idiopathic thrombocytopenic purpura. Br J Haematol 9: 95–104
Heyns AP du, Lötter MG, Badenhorst PN, Felicity de K, Pieters H, Herbst C, van Reenen OR, Kotze H, Minnaar PC (1982) Kinetics and site of destruction of Indium-oxinelabeled platelets in idiopathic thrombocytopenic purpura: A quantitative study. Am J Hematol 12: 167–177
Heyns AP du, Badenhorst PN, Lotter MG, Pieters H, Wessels P, Kotze HF (1986) Platelet turnover and kinetics in immune thrombocytopenic purpura: Results with autologous 111In-labeled platelets and homologous 51Cr-labeled platelets differ. Blood 67: 86–92
Imbach P, Barandun S, d'Apuzzo V, Baumgartner C, Hirt A, Morell A, Rossi E, Schoni M, Vest M, Wagner HP (1981) High-dose intravenous gammaglobulin for idiopathic thrombocytopenic purpura in childhood. Lancet I: 1228–1231
Kimberly RP, Salmon JE, Bussel JB, Crow MK, Hilgartner MW (1984) Modulation of mononuclear phagocyte function by intravenous gammaglobulin. J Immunol 132: 745–751
Newland AC, Teleaven JG, Minchington RM, Waters AH (1983) High-dose intravenous IgG in adults with autoimmune thrombocytopenia. Lancet I: 84–87
Schmidt KG, Rasmussen JW (1985) Kinetics and distribution in vivo of In-labelled autologous platelets in idiopathic thrombocytopenic purpura. Scand J Haematol 34: 47–56
Schmidt RE, Budde U, Schäfer G, Stroehmann I (1981) High-dose intravenous gammaglobulin for idiopathic thrombocytopenic purpura. Lancet II: 475–476
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Kawasugi, K., Matsuda, J. & Abe, T. Prediction of the effect of immunoglobulin therapy in ITP. Blut 59, 88–91 (1989). https://doi.org/10.1007/BF00320255
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DOI: https://doi.org/10.1007/BF00320255