Treatment of chronic childhood immune thrombocytopenic purpura with intramuscular anti-D immunoglobulins

Seven patients with chronic immune thrombocytopenic purpura (ITP) were treated with intramuscular anti-D (anti-D IgG) five times, on an alternate-day basis, or until a platelet count of 100 x 109/l was achieved, and, subsequently, when necessary to maintain platelet counts above 50 x 109/l. Five patients responded to therapy, two of whom entered long-term remission. Although signs of haemolysis were present in all patients, anaemia was never a problem. No patient developed haematomas at the site of injection. We suggest that intramuscular anti-D represent a safe and relatively inexpensive alternative to intravenous gamma globulin (IVGG) for children with severe chronic ITP.