Volume 77, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Because most cases of secondary dengue virus infection are associated with an increased level of platelet-associated IgG, a high dose of intravenous immunoglobulin (IVIG) may have an effect on the development of severe thrombocytopenia in this disease. A randomized, controlled study was conducted with two treatment groups consisting of a treatment (IVIG) group (n = 15) and a non-treatment (non-IVIG) group (n = 16) to determine whether a high dose of IVIG is effective in hastening the recovery from thrombocytopenia in patients with secondary dengue virus infection. No significant difference was found in the baseline demographic data between the two groups. No adverse effect of IVIG was observed, but no effect in hastening the recovery of platelet counts was found in patients with secondary dengue infections. The lack of efficacy of IVIG suggests that platelet clearance by macrophages through Fc γ receptors is not a primary mechanism in this disease.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Halstead SB, 1988. Pathogenesis of dengue: challenges of molecular biology. Science 239 : 476–481. [Google Scholar]
  2. La Russa VF, Innis BL, 1995. Mechanism of dengue virus-induced bone marrow suppression. Baillieres Clin Hematol 8 : 249–270. [Google Scholar]
  3. Oishi K, Saito M, Mapua CA, Natividad FF, 2007. Dengue illness: clinical features and pathogenesis. J Infect Chemother 13 : 125–133. [Google Scholar]
  4. Gubler DJ, 2002. Epidemic dengue/ dengue hemorrhagic fever as a public health, social and economic problems in the 21st century. Trends Microbiol 10 : 100–103. [Google Scholar]
  5. McMillan R, 1981. Chronic idiopathic thrombocytopenic purpura. N Engl J Med 304 : 1135–1147. [Google Scholar]
  6. Cines DB, Blanchette VS, 2002. Immune thrombocytopenic purpura. N Engl J Med 346 : 995–1008. [Google Scholar]
  7. Crow AR, Song S, Siragam V, Lazarus AH, 2006. Mechanisms of action of intravenous immunoglobulin in the treatment of immune thrombocytopenia. Pediatr Blood Cancer 47 : 710–713. [Google Scholar]
  8. Oishi K, Inoue S, Cinco MT, Dimaano EM, Alera MT, Alfon JA, Abanes F, Cruz DJ, Matias RR, Matsuura H, Hasebe F, Tanimura S, Kumatori A, Morita K, Natividad FF, Nagatake T, 2003. Correlation between increased platelet-associated IgG and thrombocytopenia in secondary dengue virus infections. J Med Virol 71 : 259–264. [Google Scholar]
  9. Saito M, Oishi K, Inoue S, Dimaano EM, Alera MTP, Robles MP, Estrella JR, Kumatori A, Moji K, Alonzo BMT, Buerano CC, Matias RR, Morita K, Natividad FF, Nagatake T, 2004. Association of increased platelet-associated immunoglobulins with thrombocytopenia and the severity of disease in secondary dengue virus infections. Clin Exp Immunol 138 : 299–303. [Google Scholar]
  10. Ascher DP, Laws HF, Hayes CG, 1989. The use of intravenous gammaglobulin in dengue fever, a case report. Southeast Asian J Trop Med Pub Hlth 20 : 549–554. [Google Scholar]
  11. World Health Organization, 1997. Dengue Haemorrhagic Fever: Diagnosis, Treatment, Prevention and Control. Second edition. Geneva: World Health Organization.
  12. Berlioz-Arthaud A, Marfel M, Durand AM, Ogawa T, 2005. Evaluation of a new anti-dengue virus IgM particle agglutination kit in the context of the Pacific islands. World Health Organ Dengue Bull 29 : 70–78. [Google Scholar]
  13. Bundo K, Igarashi A, 1985. Antibody-capture ELISA for detection of immunoglobulin M antibodies in sera from Japanese encephalitis and dengue hemorrhagic fever patients. J Virol Methods 11 : 15–22. [Google Scholar]
  14. Morita K, Tanaka M, Igarashi A, 1991. Rapid identification of dengue virus serotypes by using polymerase chain reaction. J Clin Microbiol 29 : 2107–2110. [Google Scholar]
  15. Clarke DH, Casals J, 1958. Techniques for hemagglutination and hemagglutination-inhibition with arthropod-borne viruses. Am J Trop Med Hyg 7 : 561–573. [Google Scholar]
  16. Kurlander RJ, Roose WF, 1986. Efficacy of a 2-day schedule for administering intravenous immunoglobulin (IVIg) in treating adults with ITP. Blood 291 : 484. [Google Scholar]
  17. Bierling P, Godeau B, 2005. Intravenous immunoglobulin for autoimmune thrombocytopenic purpura. Human Immunol 66 : 387–394. [Google Scholar]
  18. Avirutnan P, Punyanadee N, Noisaran S, Komoltri C, Thiemmeca S, Auethavornanan K, Jairungsri A, Kanlaya R, Tangtawornchailul N, Puttikhunt C, Pattnakisakul S, Yenchitsomnus P, Mongkolsapaya J, Kasinrerk W, Sittisombut N, Husmann M, Blettner M, Vasanawathana S, Bhakdi S, Mlasit P, 2006. Vascular leakage in severe dengue virus infections: a potential role for the nonstructural viral protein NS1 and complement. J Infect Dis 193 : 1078–1088. [Google Scholar]
  19. de Castro RA, de Castro JA, Barez M, Frias M, Dixit J, Genereux M, 2007. Thrombocytopenia associated with dengue hemorrhagic fever responds to intravenous administration of anti-D (Rh(0)-D) immune globulin. Am J Trop Med Hyg 76 : 737–742. [Google Scholar]
  20. Scaradavou A, Woo B, Woloski BM, Cunningham-Rundles S, Ettinger LJ, Aledort LM, Bussel JM, 1997. Intravenous anti-D treatment of immune thrombocytopenic purpura: experience in 272 patients. Blood 89 : 2689–2700. [Google Scholar]

Data & Media loading...

  • Received : 22 Aug 2007
  • Accepted : 28 Aug 2007

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error