Intravenous Anti-D immunoglobulin for control of life threatening bleed in dengue hemorrhagic fever with severe thrombocytopenia

Article type: Research Article

Authors: Nirupam, Nilay | Kumar, Sandeep | Badatya, Sushant | Chhapola, Viswas | Sharma, Rajni | Kumar, Virendra

Affiliations: Department of Pediatrics, Division of Pediatric Intensive Care, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India

Note: [] Correspondence: Viswas Chhapola, Department of Pediatrics, Lady Hardinge Medical College, New Delhi-110001, India. Tel.: +91 9212374782; E-mail: [email protected]

Abstract: We report an eight-year-old girl with Dengue Hemorrhagic Fever, shock and a life-threatening upper gastrointestinal and pulmonary bleed with refractory thrombocytopenia. She received 6 units of random donor platelets, 1 unit of single donor platelets, 1 unit of packed red cells and 4 units of fresh frozen plasma to control bleeding but had no response. Finally, 36 hour after onset of bleed intravenous Anti-D 75 μg/kg was given and she had a dramatic increase in platelet counts and cessation of all clinical bleed. This case report highlights that intravenous Anti-D can be a treatment option in Dengue Hemorrhagic Fever with severe refractory thrombocytopenia and massive bleeding.

Keywords: Dengue hemorrhagic fever, Anti-D, thrombocytopenia

DOI: 10.3233/JPI-120358

Journal: Journal of Pediatric Infectious Diseases, vol. 7, no. 3, pp. 127-130, 2012