Immunotherapy of idiopathic thrombocytopenic purpura and autoimmune neutropenia

Idiopathic thrombocytopenic purpura (ITP) is a disorder characterized by a low platelet count and purpura. Identification of an antiplatelet antibody suggests that this is an autoimmune disease. Corticosteroids and splenectomy have been the major therapies for many years. High-dose intravenous immune globulin (IV-IgG) has been very successful in the management of ITP and has recently received FDA approval for this condition. It was also successful when administered to a few patients with autoimmune neutropenia. The exact mechanism of action of IV-IgG in autoimmune disorders is poorly understood. Currently, high-dose IV-IgG has a definite place in the management of ITP. Its role in therapy includes emergency treatment, preoperative preparation, the postponement of splenectomy in young children, and treatment of ITP during pregnancy.