Marumoto Akira, Ashida Yasushi, Kuroda Hiroaki, Hamasaki Takafumi, Kamihira Satoshi, Ishiguro Shingo, Ohgi Shigetsugu
Department of Surgery, Division of Organ Regeneration Surgery, Faculty of Medicine, Tottori University, Tottori, Japan.
Ann Thorac Cardiovasc Surg. 2005 Feb;11(1):48-50.
A 63-year-old woman with an 18-year history of idiopathic thrombocytopenic purpura (ITP) was admitted with a persistent fever of unknown cause. Blood culture was positive for alpha-Streptococcus and echocardiography revealed severe mitral regurgitation and vegetation on the mitral valve. After antimicrobial therapy for six weeks, she underwent mitral valve repair using a Cosgrove ring. The platelet count increased and remained stable by perioperative treatment with intravenous high-dose gamma-globulin and platelet transfusion without steroids therapy or splenectomy. The hospital course was uneventful. Perioperative high-dose gamma-globulin therapy and platelet transfusion for the cardiac operation were useful to increase and maintain the platelet count for an ITP patient complicated with infective endocarditis.
一名患有特发性血小板减少性紫癜（ITP）18年的63岁女性因不明原因持续发热入院。血培养显示α-链球菌阳性，超声心动图显示严重二尖瓣反流及二尖瓣赘生物。抗菌治疗六周后，她使用科斯格罗夫环进行了二尖瓣修复术。通过围手术期静脉注射大剂量γ-球蛋白和血小板输注治疗，未使用类固醇疗法或脾切除术，血小板计数增加并保持稳定。住院过程顺利。对于合并感染性心内膜炎的ITP患者，围手术期大剂量γ-球蛋白治疗和心脏手术中的血小板输注有助于增加并维持血小板计数。
