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VOLUME 21 , ISSUE 2 ( 2017 ) > List of Articles


Safety and efficacy of a single dose of Anti-D (WinRho®) in severe thrombocytopenia secondary to dengue virus infection

Subhash Varma, Mayank Singhal, Ashok Pannu

Keywords : Anti-D, dengue, thrombocytopenia

Citation Information : Varma S, Singhal M, Pannu A. Safety and efficacy of a single dose of Anti-D (WinRho®) in severe thrombocytopenia secondary to dengue virus infection. Indian J Crit Care Med 2017; 21 (2):80-84.

DOI: 10.4103/ijccm.IJCCM_386_16

License: CC BY-ND 3.0

Published Online: 01-02-2018

Copyright Statement:  Copyright © 2017; The Author(s).


Objective: To evaluate the efficacy of a single intravenous (IV) dose of anti-D in severe thrombocytopenia (<20,000) due to dengue virus (DEV) infection. Materials and Methods: An open label, investigator-initiated, randomized interventional study was conducted that included thirty dengue patients (all positive for IgM enzyme-linked immunosorbent assay) with severe thrombocytopenia (<20,000/mm3). Patients were randomized to receive anti-D (50 μg/kg single IV dose) plus supportive therapy or supportive therapy alone. Results: The rate of rise in platelet count was significantly high in the intervention group at 24, 36, and 48 h. At the end of 48 h, 60% patients in the intervention group achieved a platelet count of ≥50,000/mm3 as compared to 6.7% in the control group (P = 0.0019). The requirement of the platelet concentrate infusion in the control group was significantly higher, i.e. 342 ml (±193) as compared to the intervention group requiring only 187 ml (±79). The intervention group showed a significant improvement in bleeding manifestations in all the patients by 24 h in Grade 2 bleed (P = 0.032) and by 48 h in Grade 1 bleed (P = 0.014). Conclusions: Severe thrombocytopenia (≤20,000/mm3) secondary to DEV infection was rapidly and safely reversed by administration of a single dose of 50 μg/kg (250 IU/kg) anti-D IV.

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