Clinical Features and Results
Between January 2010 and January 2020, the number of patients using
IVIGs was 166. Of these patients, 71 were female (42.8%) and 95 were
male (57.2%). Indications for IVIGs were listed as follows. Immune
thrombocytopenic purpura (ITP), chronic lymphocytic leukemia (CLL),
autoimmune hemolytic anemia (AIHA), myelodysplastic syndrome (MDS),
aplastic anemia (AA), combined variable immune deficiency syndrome
(CVID), acute myeloid leukemia (AML) lymphoblastic leukemia (ALL),
Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL), multiple myeloma
(MM), myelofibrosis, Waldenström macroglobulinemia (WM), hairy cell
leukemia (HCL), pure red cell aplasia (PRCA), acquired immune deficiency
syndrome (AIDS), systemic lupus erythematosus (SLE), Castleman Disease,
sickle cell anemia and lung cancer. The wide range of diseases in our
study is explained as follows: Patients who applied to the emergency
department or hematology outpatient clinic with thrombocytopenia and who
were treated as immune thrombocytopenic purpura at first and who took
IVIG together with glucocorticosteroids according to the emergency
treatment plan, received different diagnoses after their advanced
examinations. Therefore, patients were divided into two groups: Those
who were diagnosed before or after using IVIGs.
It is underlined that an approval has been obtained at the point of
using IVIGs in indications not included in the health safety system and
hea
It is important to note that different doses of glucocorticosteroids
have been used together in all cases of thrombocytopenia, which are
thought to be of immune origin. Patients with the diagnosis of ITP were
refractory cases under different doses of glucocorticoids, also it was
observed that similarly different doses of glucocorticoids were used
together with IVIG. Except for steroids, there was no patient diagnosed
with ITP who received another type of immunosuppressive. For a
autoimmune hemolytic anemia patient, methylprednisolone was used in
doses that were tried to be reduced starting from 1 mg/kg for 2 months.
Afterwards, weekly rituximab treatment was started due to recurrence;
but there was no response.
66 of 166 patients were diagnosed with ITP (39.8%), 19 CLL (11.4%), 1
autoimmune hemolytic anemia (0.6%), 8 MDS (4.8%), 5 aplastic anemia
(3%), 3 CVID (1.8%), 11 AML (6.6%), 8 ALL (4.8%), 4 Hodgkin lymphoma
(2.4%), 14 non-Hodgkin lymphoma (8.4%), 14 myeloma (8.4%), 1
myelofibrosis (0.6%), 1 Waldenström macroglobulinemia (0.6%), 1 Hairy
Cell Leukemia (0.6%), 2 PRCA (1.2%), 3 AIDS (1.8%), 1 SLE (0.6%), 1
Castleman Disease, 2 sickle cell anemia (1.2%) and 1 lung cancer.
Disease and gender distribution of the patients are given in Table 1. We
should emphasize that all patients for whom IVIGs were used before
getting primary diagnosis were thrombocytopenic. This usage was
indicated in emergency conditions and emergency treatment. In this
context, we see that the number of patients who were used IVIG before
getting a primary diagnosis was 79 (47.6%) and 41 of whom (51.9%) were
diagnosed with immune thrombocytopenic purpura. In the remaining
distribution, 2 patients were diagnosed with KLL (2.5%), 7 patients
with MDS (8.9%), 5 patients with aplastic anemia (6.3%), 7 patients
with AML (8.9%), 7 patients with ALL (8.9%), 7 patients with NHL
(8.9% ), 1 patient with lung cancer (1.3%), 1 patient was
myelofibrosis (1.3%), and 1 patient was diagnosed with AIDS (1.3%).
Patients and their clinical-gender distributions are given in