Comparison of anti-D immunoglobulin and dexamethasone in chronic and persistent forms of pediatric immune thrombocytopenic purpura

Bakcground: The aim of ITP treatment is to prevent intracranial hemorrhage and increase the platelet count rapidly. This study was conducted with the objective of comparing the efficacy of anti-D immunoglobulin (Ig) with dexamethasone in treating childhood ITP.
In this randomized prospective control trial, 20 ITP patients (Platelet count In this study, 20 patients [11 girls (55%) and 9 boys (45%)] with the mean age of 5.6±4 years were enrolled. From the total number, 13 (65%) were younger than 5 years old, 4 (20%) aged between 5 and 10, and 3 (15%) were older than 10. There was no significant difference between the two groups regarding sex and age. In both groups the most common symptom was cutaneous manifestations (purpura, ecchymoses) (63.6% vs. 36.4% p=0.325). At enrolment time, the mean disease duration was 28±21 months, ranging from 5 to 132 months. Out of 20 patients, 9 (45%) suffered from chronic ITP, and 11 (55%) were in persistent phase of the disease. No significant difference was observed between the two groups regarding the frequency of chronic and persistent cases (p=0.370). Similarly, the follow-up platelet count four months after the treatment showed no significant difference between the two groups (p=0.241).
The findings of this study did not confirm the priority of dexamethasone over anti-D Ig. The hemolytic side effects of anti-D were negligible compared to dexamethasone.