Background:
We reported the results of low-dose and short-term intravenous immnuoglobulin G (IVIG) therapy to raise the platelet count over 100,000/㎣ for childhood acute idiopathic thrombocytopenic purpura (ITP) according to the
individual clinical response. The effects had no differences in two groups between low-dose and full-dose. This study was conducted to compare the recurrence rate and chronicity in patients who were given IVIG according to the individual clinical course until the platelet counts over 50,000/㎣.
Methods:
The low-dose and short-term IVIG therapy (400㎎/㎏/day) until rising the platelet counts over 50,000/㎣ was attempted in 68 childhood ITP who were diagnosed at the Department of Pediatrics, Kyungpook National University Hospital from September, 1993 to April, 2001. The patients rising the platelet counts over 50,000/㎣ after 1∼2, 3∼4, and 5 or more doses of IVIG were defined a rapid, intermediate and slow responder (RR, IR, and SR).
Results:
The median age was 3.2 years and male to female ratio was 2.6:1 and the median duration of follow up was 2.1 years. Among 47 cases who were followed up over 6 months, 14 cases (29.8%) were into chronic ITP. The days of IVIG therapy
was one in 10, two in 19, three in 17, four in 7, five in 5, six in 3, seven in 1, eight in 3, nine in 1, twelve in 1 and fourteen in one children. The median platelet counts was 16,180±10,309/㎣ at diagnosis and was increased to 36,164±27,570/㎣ after 1 day, 76,076±56,463/㎣ after 2 days, 107,470±68,236/㎣ after 3 days, 95,814±52,473/㎣ after 4 days and 109,850±56,785/㎣ after 5 days of IVIG therapy. But the platelet count was not increased above 100,000/㎣ in 7 cases among those who were given over 4 days or more IVIG therapy. The platelet counts began to rise above 50,000/㎣ at 2.9 days, 100,000/㎣ at 4.0 days and 150,000/㎣ at 4.6 days of IVIG therapy. Four of 29 RR, 5 of 24 IR and 7 of 15 SR were relapsed (P value of RR vs SR=0.028). Seven of 28 RR, 1 of 11 IR and 6 of 8 SR became a chronic type (P value of RR vs SR=0.016, IR vs SR=0.006).
Conclusion:
The low-dose and short-term IVIG according to the individual clinical response may be a desirable method for the treatment of childhood acute ITP.

Keywords: Immune thrombocytopenic pur-pura, Childhood, Intravenous immnuoglobulin G, Low-dose, Short-term