Back to Browse Journals » Biologics: Targets and Therapy » Volume 3

Anti-RhD immunoglobulin in the treatment of immune thrombocytopenia

Authors Eric Cheung, Howard A Liebman

Published 8 January 2009 Volume 2009:3 Pages 57—62


Review by Single-blind

Peer reviewer comments 3

Eric Cheung, Howard A Liebman

Jane Anne Nohl Division of Hematology and Center for the Study of Blood Diseases, University of Southern California-Keck School of Medicine, Los Angeles, CA, USA

Abstract: Immune thrombocytopenia (ITP) is an acquired bleeding autoimmune disorder characterized by a markedly decreased blood platelet count. The disorder is variable, frequently having an acute onset of limited duration in children and a more chronic course in adults. A number of therapeutic agents have demonstrated efficacy in increasing the platelet counts in both children and adults. Anti-RhD immunoglobulin (anti-D) is one such agent, and has been successfully used in the setting of both acute and chronic immune thrombocytopenia. In this report we review the use of anti-D in the management of ITP. While the FDA-approved dose of 50 mg/kg has documented efficacy in increasing platelet counts in approximately 80% of children and 70% of adults, a higher dose of 75 μg/kg has been shown to result in a more rapid increase in platelet count without a greater reduction in hemoglobin. Anti-D is generally ineffective in patients who have failed splenectomy. Anti-RhD therapy has been shown capable of delaying splenectomy in adult patients, but does not significantly increase the total number of patients in whom the procedure can be avoided. Anti-D therapy appears to inhibit macrophage phagocytosis by a combination of both FcR blockade and inflammatory cytokine inhibition of platelet phagocytosis within the spleen. Anti-RhD treatment is associated with mild to moderate infusion toxicities. Rare life-threatening toxicities such as hemoglobinuria, acute renal failure and disseminated intravascular coagulation have been reported. Recommendations have been proposed to reduce the risk of these complications. Anti-D immunoglobulin can be an effective option for rapidly increasing platelet counts in patients with symptomatic ITP.

Keywords: immune thrombocytopenia, RhD immunoglobulin

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF] 


Readers of this article also read:

Ultrasmall cationic superparamagnetic iron oxide nanoparticles as nontoxic and efficient MRI contrast agent and magnetic-targeting tool

Uchiyama MK, Toma SH, Rodrigues SF, Shimada AL, Loiola RA, Cervantes Rodríguez HJ, Oliveira PV, Luz MS, Rabbani SR, Toma HE, Poliselli Farsky SH, Araki K

International Journal of Nanomedicine 2015, 10:4731-4746

Published Date: 28 July 2015

Sex differences in TGFB-β signaling with respect to age of onset and cognitive functioning in schizophrenia

Frydecka D, Misiak B, Pawlak-Adamska E, Karabon L, Tomkiewicz A, Sedlaczek P, Kiejna A, Beszłej JA

Neuropsychiatric Disease and Treatment 2015, 11:575-584

Published Date: 5 March 2015

The relationship between Graves’ ophthalmopathy and dry eye syndrome

Selter JH, Gire AI, Sikder S

Clinical Ophthalmology 2015, 9:57-62

Published Date: 31 December 2014

Association of genetic polymorphisms with chronic obstructive pulmonary disease in the Hainan population: a case-control study

Ding YP, Yang DL, Xun XJ, Wang ZF, Sun P, Xu DC, He P, Niu H, Jin TB

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:7-13

Published Date: 17 December 2014

Decreased mean platelet volume in panic disorder

Göğçegöz Gül I, Eryılmaz G, Özten E, Hızlı Sayar G

Neuropsychiatric Disease and Treatment 2014, 10:1665-1669

Published Date: 4 September 2014

Treatment of nephrotic syndrome with adrenocorticotropic hormone (ACTH) gel

Andrew S Bomback, James A Tumlin, Joel Baranski, et al

Drug Design, Development and Therapy 2011, 5:147-153

Published Date: 14 March 2011