Pediatrics

Biography

Biography: Dr Kun Soo Lee

Abstract

The main reason for intravenous immunoglobulin G (IVIG) treatment in acute phase of immune thrombocytopenic purpura (ITP) is prevention of possible life-threatening hemorrhage since 1981. On the 1st trial, I just followed the dose of 400 mg/kg/d of IVIG for 5 days for 8 patients with good result in 1983-1984 (Korean J Pediatr. 28:483-491, 1985). On the 2nd, I stopped medication when platelet was over 100,000 /μL for 73 in 1985-1993. Mean treatment days were 2.8 days. The relapse and chronic ITP was less developed in rapid responders (RR: 1-3 treatment days) than in slow responders (SR: more than 3 days) (P<0.05) (Korean J Hematol 2001;36:241-6).  On the 3rd, I also stopped medication when the platelet was over 50,000 /μL for 68 in 1993-2001. Mean treatment days were 2.9 days. Seven of 28 RR and 6 of 8 SR were chronic type (p=0.016) (Korean J Hematol 2001;36:247-52). On the 4th, I reduced daily dose to 200 mg/kg/d when the platelet was over 50,000/μL for 26 in 2005-2006. Average 2 days treatment were needed to increase the platelet count 50,000/μL. Although all 10 non re-treat group who were follow-up over 6 months were acute, all 3 re-treat group who were follow-up over 6 months were chronic (p<0.003) (Clin Pediatr Hematol Oncol 2006;13:143-9). No one died with 4 studies. The IVIG dose was different according to one’s clinical response. In some patient only 1/10 of usual doses (2 g/kg) were sufficient to reach a safe platelet counts in usual life.