Successful intravenous immune globulin therapy for human immunodeficiency virus-associated thrombocytopenia

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Abstract
• High-dose intravenous (IV) Immune globulin was used to treat human immunodeficiency virus (HIV)—associated thrombocytopenia four times in three patients. The average platelet count at initiation of therapy was 12×109/L (12×103/mm3), and the platelet count after therapy was 159×109/L (159×103/mm3), giving a mean Increase of 147×109/L 147×103/mm3) (1225%). The conditions of two of these patients were refractory to corticosteroids, but giving IV immune globulin along with steroids appeared to enhance the response to IV immune globulin. A review of the literature revealed that 53 (88%) of 60 patients with HIV-associated thrombocytopenia responded to IV immune globulin with platelet counts greater than 50× 109/L (50×103/mm3). We conclude that IV immune globulin therapy achieves transient elevations in platelet counts to levels that control bleeding and permit surgery in patients with severe, HIV-associated thrombocytopenia. (Arch Intern Med1988;148:695-697)