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Recently, addition of a Food and Drug Administration\u2010mandated black box warning highlighted the risks of intravascular hemolysis, renal failure, and disseminated intravascular coagulation after anti\u2010D infusion, prompting concern within the medical community regarding its use. A working group convened in response to this warning to prepare a consensus document regarding the safety of RhIG because there has been no increased incidence of adverse events since the initial discovery of these reactions many years ago. The efficacy of anti\u2010D is well documented and only briefly reviewed. The estimated incidence and proposed mechanisms for the rare, major treatment\u2010related complications are discussed, and signal detection data associated with heightened risk of acute hemolytic reactions are presented. The importance of considering host factors, given the rarity of severe reactions, is emphasized. Safety profiles of parallel treatment options are reviewed. The working group consensus is that RhIG has comparable safety and efficacy to other front\u2010line agents for the treatment of children and adults with ITP. Safety may be further improved by careful patient selection.<\/jats:p>","DOI":"10.1111\/j.1537-2995.2011.03384.x","type":"journal-article","created":{"date-parts":[[2011,10,7]],"date-time":"2011-10-07T21:13:44Z","timestamp":1318022024000},"page":"1126-1136","source":"Crossref","is-referenced-by-count":55,"title":["RhIG for the treatment of immune thrombocytopenia: consensus and controversy (CME)"],"prefix":"10.1111","volume":"52","author":[{"given":"Jenny M.","family":"Despotovic","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele P.","family":"Lambert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay H.","family":"Herman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terry B.","family":"Gernsheimer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith R.","family":"McCrae","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Tarantino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James B.","family":"Bussel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,10,7]]},"reference":[{"key":"e_1_2_13_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra010501"},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI113060"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.2147\/BTT.S3436"},{"key":"e_1_2_13_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOH.0b013e32833eaef3"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V87.10.4245.bloodjournal87104245"},{"key":"e_1_2_13_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/nm921"},{"key":"e_1_2_13_8_2","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.12889."},{"key":"e_1_2_13_9_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.1996.d01-1702.x"},{"key":"e_1_2_13_10_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.1998.00683.x"},{"key":"e_1_2_13_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2009.07717.x"},{"key":"e_1_2_13_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.20992"},{"key":"e_1_2_13_13_2","doi-asserted-by":"publisher","DOI":"10.1159\/000089465"},{"key":"e_1_2_13_14_2","doi-asserted-by":"publisher","DOI":"10.1080\/08880010290097161"},{"key":"e_1_2_13_15_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V89.8.2689"},{"key":"e_1_2_13_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2005.11.019"},{"key":"e_1_2_13_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0b013e31817541ba"},{"key":"e_1_2_13_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2004.04804.x"},{"issue":"1","key":"e_1_2_13_19_2","first-page":"14","article-title":"Anti\u2010D: mechanisms of action","volume":"35","author":"Ware RE","year":"1998","journal-title":"Semin Hematol"},{"key":"e_1_2_13_20_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2001.02627.x"},{"key":"e_1_2_13_21_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V95.8.2523"},{"key":"e_1_2_13_22_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2004-11-4303"},{"key":"e_1_2_13_23_2","unstructured":"Food and Drug Administration.US FDA black\u2010box warning.2011. 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