Patients with thalassemia major due to red blood cell autoantibodies may develop an increase in transfusional blood consumption. In this study we report the results of treatment with high intravenous immunoglobulin (Ig) in 4 patients who developed an increase in blood consumption related to the presence of autoantibodies of defined or undefined specificities. Three patients showed a normalization of the blood consumption. No adverse effects were detected. These results indicate that high-dose intravenous Ig therapy is indicated in patients with thalassemia major manifesting an increase in blood consumption following the development of red cell autoantibodies.