Intravenous immunoglobulin–induced acute thrombocytopenia

Anna Gurevich-Shapiro; Lilach Bonstein; Galia Spectre; Nardeen Atweh; Tsipora Gruenewal; Michael Shapiro; Boaz Tadmor; Pia Raanani

doi:10.1111/trf.14419

Intravenous immunoglobulin–induced acute thrombocytopenia

Anna Gurevich-Shapiro, Lilach Bonstein, Galia Spectre, Nardeen Atweh, Tsipora Gruenewal, Michael Shapiro^*, Boaz Tadmor, Pia Raanani

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

Abstract

BACKGROUND: Intravenous immunoglobulin (IVIG) has known efficacy in various hematologic conditions, including immune thrombocytopenic purpura. STUDY DESIGN AND METHODS: We present the clinical course of a patient with splenic marginal zone lymphoma, who developed acute thrombocytopenia on three consecutive episodes, with nadir counts of 27 × 10⁹, 50 × 10⁹, and 9 × 10⁹/L, upon administration of Intratect IVIG for hypogammaglobulinemia. An immunofluorescence test applying flow cytometry and monoclonal antibody immobilization of platelet antigens (MAIPA) assay were used to evaluate the reaction between IgG present in the IVIG preparations and the patient's or healthy donors' platelets (PLTs). RESULTS: A strong direct binding reaction was observed between the patient's PLTs and Intratect IgG using both methods. A similar reaction failed to materialize with controls. Binding was not antigen specific according to MAIPA. CONCLUSIONS: This is the first reported case of thrombocytopenia as a possible adverse effect of IVIG.

Original language	English
Pages (from-to)	493-497
Number of pages	5
Journal	Transfusion
Volume	58
Issue number	2
DOIs	https://doi.org/10.1111/trf.14419
State	Published - Feb 2018

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1111/trf.14419

Cite this

@article{bbb1dab7326a427bbddd8bf872a60975,

title = "Intravenous immunoglobulin–induced acute thrombocytopenia",

abstract = "BACKGROUND: Intravenous immunoglobulin (IVIG) has known efficacy in various hematologic conditions, including immune thrombocytopenic purpura. STUDY DESIGN AND METHODS: We present the clinical course of a patient with splenic marginal zone lymphoma, who developed acute thrombocytopenia on three consecutive episodes, with nadir counts of 27 × 109, 50 × 109, and 9 × 109/L, upon administration of Intratect IVIG for hypogammaglobulinemia. An immunofluorescence test applying flow cytometry and monoclonal antibody immobilization of platelet antigens (MAIPA) assay were used to evaluate the reaction between IgG present in the IVIG preparations and the patient's or healthy donors' platelets (PLTs). RESULTS: A strong direct binding reaction was observed between the patient's PLTs and Intratect IgG using both methods. A similar reaction failed to materialize with controls. Binding was not antigen specific according to MAIPA. CONCLUSIONS: This is the first reported case of thrombocytopenia as a possible adverse effect of IVIG.",

author = "Anna Gurevich-Shapiro and Lilach Bonstein and Galia Spectre and Nardeen Atweh and Tsipora Gruenewal and Michael Shapiro and Boaz Tadmor and Pia Raanani",

note = "Publisher Copyright: {\textcopyright} 2017 AABB",

year = "2018",

month = feb,

doi = "10.1111/trf.14419",

language = "אנגלית",

volume = "58",

pages = "493--497",

journal = "Transfusion",

issn = "0041-1132",

publisher = "John Wiley and Sons Inc.",

number = "2",

}

TY - JOUR

T1 - Intravenous immunoglobulin–induced acute thrombocytopenia

AU - Gurevich-Shapiro, Anna

AU - Bonstein, Lilach

AU - Spectre, Galia

AU - Atweh, Nardeen

AU - Gruenewal, Tsipora

AU - Shapiro, Michael

AU - Tadmor, Boaz

AU - Raanani, Pia

PY - 2018/2

Y1 - 2018/2

N2 - BACKGROUND: Intravenous immunoglobulin (IVIG) has known efficacy in various hematologic conditions, including immune thrombocytopenic purpura. STUDY DESIGN AND METHODS: We present the clinical course of a patient with splenic marginal zone lymphoma, who developed acute thrombocytopenia on three consecutive episodes, with nadir counts of 27 × 109, 50 × 109, and 9 × 109/L, upon administration of Intratect IVIG for hypogammaglobulinemia. An immunofluorescence test applying flow cytometry and monoclonal antibody immobilization of platelet antigens (MAIPA) assay were used to evaluate the reaction between IgG present in the IVIG preparations and the patient's or healthy donors' platelets (PLTs). RESULTS: A strong direct binding reaction was observed between the patient's PLTs and Intratect IgG using both methods. A similar reaction failed to materialize with controls. Binding was not antigen specific according to MAIPA. CONCLUSIONS: This is the first reported case of thrombocytopenia as a possible adverse effect of IVIG.

AB - BACKGROUND: Intravenous immunoglobulin (IVIG) has known efficacy in various hematologic conditions, including immune thrombocytopenic purpura. STUDY DESIGN AND METHODS: We present the clinical course of a patient with splenic marginal zone lymphoma, who developed acute thrombocytopenia on three consecutive episodes, with nadir counts of 27 × 109, 50 × 109, and 9 × 109/L, upon administration of Intratect IVIG for hypogammaglobulinemia. An immunofluorescence test applying flow cytometry and monoclonal antibody immobilization of platelet antigens (MAIPA) assay were used to evaluate the reaction between IgG present in the IVIG preparations and the patient's or healthy donors' platelets (PLTs). RESULTS: A strong direct binding reaction was observed between the patient's PLTs and Intratect IgG using both methods. A similar reaction failed to materialize with controls. Binding was not antigen specific according to MAIPA. CONCLUSIONS: This is the first reported case of thrombocytopenia as a possible adverse effect of IVIG.

UR - http://www.scopus.com/inward/record.url?scp=85041393457&partnerID=8YFLogxK

U2 - 10.1111/trf.14419

DO - 10.1111/trf.14419

M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???

C2 - 29193103

AN - SCOPUS:85041393457

SN - 0041-1132

VL - 58

SP - 493

EP - 497

JO - Transfusion

JF - Transfusion

IS - 2

ER -

Intravenous immunoglobulin–induced acute thrombocytopenia

Abstract

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this