Objective: The objetive of our study is to assess the utility of the subtypes IgG direct Coombs test (DCT) in maintenance apomorphine treatment without risk of hemolytic anemia (HA). The subtypes 1 and 3 are associated with high risk. However, subtypes 2 and 4 have very low risk of this complication.

Background: An undesired complication in the management of patients with advanced Parkinson’s disease (APD) in treatment with continuous infusion of apomorphine is HA.

Methods: Between 2011-2015 we have implanted 22 infusion sets and used the DCT with Ag as a method of control. This is a cohort of 22 patients with APD (7 women and 15 men) with a mean age 61.3 (range 52-85). The mean progression of Parkinson’s disease was 15 years (range 11-26) with Hohen and Yahr stage at the time of implantation between 2.5-4.5 (mean 3.18). The flow of perfusion ranged between 3.09-4.17 mg per hour and the duration between 14 to 24 hours a day. As an added standard Levodopa medication alone they had an average of 1044.7 mg. All they are made blood controls and DCT every 6 months.

Results: In four patients aged between 56 and 76 years DCT antigens were detected with positive IgG. Three of them maintenance the bomb because had the subtypes 2 and/or 4. The mean of treatment was 26 months (range 15-43). We have made controls every month (range 4-10 months) without complications.

Conclusions: Applying IgG subtypes is more sensitive than DCT simple and allows drug withdrawal avoiding the possibility of HA or maintenance apomorphine treatment with very low risk.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/utility-of-iggs-subtypes-in-hemolytic-anemia-prevention-and-treatment-maintenance-in-patients-treated-with-continous-infusion-of-apomorphine/