Intravenous immunoglobulins ameliorate thrombin‐related platelet functions in childhood immune thrombocytopenia

Abstract

SummaryChildhood immune thrombocytopenia (ITP) is an acquired haematological disorder characterized by low platelet counts, with a disease course which is usually benign and self‐limiting within 3–12 months. An estimated 28%, however, continue to develop chronic ITP and may experience bleeding symptoms and an impaired quality of life. Treatment options in case of severe bleedings include corticosteroids, anti‐D or intravenous immunoglobulins (IVIg). The general working mechanism of IVIg remains unresolved and a matter of debate. Schmugge et al now identify that IVIg may have the ability to improve thrombin‐induced platelet activation and enhance thrombin generation in a prospective study of 23 children with primary ITP, demonstrating that besides increasing platelet counts IVIg can be efficacious on the level of thrombin‐induced platelet activation and coagulation support.Commentary on: Schmugge et al. IVIg treatment increases thrombin activation of platelets and thrombin generation in paediatric patients with immune thrombocytopenia. Br J Haematol 2023;201:1209–1219.