This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow An erratum has been published
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via ISI Web of Science (13)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Holt, D.
Right arrow Articles by Slayton, W. B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Holt, D.
Right arrow Articles by Slayton, W. B.
Related Collections
Right arrow Blood

PEDIATRICS Vol. 111 No. 1 January 2003, pp. 87-90

Response to Intravenous Immunoglobulin Predicts Splenectomy Response in Children With Immune Thrombocytopenic Purpura

Derick Holt, BS||, Justin Brown, MPH§,¶, Kelly Terrill, PharmD*, Robert Goldsby, MD*, Rebecka L. Meyers, MD{ddagger}, Jody Heximer, RN*, Beth Nordfors, RN* and William B. Slayton, MD*

* Department of Pediatrics, Divisions of Hematology/Oncology
{ddagger} Surgery
§ Department of Family and Preventive Medicine
|| Department of Oncological Sciences, University of Utah School of Medicine
Thrasher Research Fund, Salt Lake City Utah

--> Objective. Response to intravenous immunoglobulin (IVIG) has been shown to predict response to splenectomy in adults with immune thrombocytopenic purpura (ITP). However, reports in children have been inconsistent. We sought to determine whether response to IVIG is predictive of response to splenectomy in children.

Methods. Thirty-two assessable children were identified by a retrospective chart review. Response was graded according to previously published criteria as follows: "excellent" (platelets >150 000 within 1 week), "good" (platelets between 50 000 and 150 000), and "poor" (platelets <50 000). "Response" refers to both splenectomy and IVIG, and response to splenectomy was counted only when it was durable.

Results. Twenty-one of 23 patients who had a good or excellent response to IVIG also had an excellent response to splenectomy. Six of 9 patients who had a poor response to IVIG also had a poor response to splenectomy. Response to IVIG was a sensitive predictor of response to splenectomy in 88% of patients. Response to IVIG had a specificity of 75%, a positive predictive value of 91%, and a negative predictive value of 67%. Response to prednisone and length of time to splenectomy were not correlated with splenectomy response.

Conclusions. These results suggest that response to IVIG is predictive of response to splenectomy in children with chronic ITP. This correlation may be of value in deciding whether a splenectomy should be performed in children with chronic ITP.

Key Words: ITP • splenectomy • intravenous immunoglobulin

Abbreviations: ITP, immune thrombocytopenic purpura • IVIG, intravenous immunoglobulin • ANA, antinuclear antibodies • SLE, systemic lupus erythematosus

Received for publication Jan 4, 2002; Accepted May 9, 2002.




This article has been cited by other articles:


Home page
 haematolHome page
R. S. Go, K. L. Johnston, and K. C. Bruden
The association between platelet autoantibody specificity and response to intravenous immunoglobulin G in the treatment of patients with immune thrombocytopenia
Haematologica, February 1, 2007; 92(2): 283 - 284.
[Abstract] [Full Text] [PDF]