다양한 질환에서 사용된 IVIG의 효능 및 혈소판 수치변화에 미치는 영향

Abstract

Intravenous immunoglobulin (IVIG) is sued in the treatment of primary and secondary antibody deficiencies and immunoregulatory disorders such as Kawasaki disease and idiopathic thrombocytopenic purpura (ITP). The platelet count after IVIG therapy in ITP was studied a lot, however the change of platelet counts in other condition was rarely reported. We intended to analyze the change of platelet counts after administration of IVIG in various conditions. The patients administered IVIG at the department of pediatrics, Keimyung university Dongsan medical center were reviewed retrospectively from Jan 2001 to Feb 2003. Various conditions and platelet count before and after IVIG administration were analyzed. IVIG was administered in 411 patients during the study period, 335 infections, 33 Kawasaki disease, 21 ITP, 15 ABO incompatibility, 4 Guillain-Barre syndrome and 3 immunodeficiency, listed in order. Their mean age was 24.9±45.7 months. Mean platelet counts before and after IVIG treatment were 181, 722/μL to 237, 340/μL in infection, 419, 879/μL to 536, 879/μL in Kawasaki disease, 16, 095/μL to 162, 143/μL in ITP and 279, 267/μL to 289, 333/μL in ABO incompatibility, where all the changes were statistically significant (P<0.01). The platelet count change due to the dosage of IVIG was most significant in high dose group (P<0.001). The number of patients (excluding Guillain-Barre syndrome and immunodeficiency) with thrombocytopenia before treatment was decreased after treatment. Normal platelet count was found in 166 patients before treatment and 235 patients after treatment whereas thrombocytosis was found in 32 and 60, respectively. Adverse reaction of IVIG administration was not serious.