Rarick M U, Montgomery T, Groshen S, Sullivan-Halley J, Jamin D, Mazumder A, Gill P S, Loureiro C, Levine A M
Department of Internal Medicine, University of Southern California School of Medicine, Los Angeles.
Am J Hematol. 1991 Dec;38(4):261-6. doi: 10.1002/ajh.2830380402.
Fourteen patients with sexually transmitted human immunodeficiency virus (HIV)-related immune thrombocytopenia were treated with intravenous gammaglobulin (IVIG). The patients were treated with a uniform program consisting of 1 g/kg of IVIG on day 1 and day 2, followed by 1 g/kg on day 15. Most patients had pretreatment bleeding symptoms, which included petechiae, spontaneous and traumatic ecchymoses, gum bleeding, and epistaxis. Median baseline platelet count was 17,000/mm3 (range 3-61,000/mm3). After the infusion of the IGIV, all patients had a resolution of their bleeding by day 8. The median maximum platelet count achieved with the IGIV was 220,000/mm3 (range 76-426,000/mm3). No patient achieved either a sustained complete or partial remission after the conclusion of the IVIG therapy. Toxicities were minimal with the majority being headache and nausea. In conclusion, patients with sexually transmitted HIV infection and immune thrombocytopenia respond favorably to IVIG. This treatment should be considered as first-line therapy for patients with HIV-related immune thrombocytopenia who require immediate but temporary increase in their platelet count, attributable to symptoms or signs of clinical bleeding or because of the need for an invasive procedure.
14例性传播的人类免疫缺陷病毒（HIV）相关免疫性血小板减少症患者接受了静脉注射丙种球蛋白（IVIG）治疗。患者接受统一方案治疗，第1天和第2天给予1g/kg的IVIG，随后在第15天给予1g/kg。大多数患者治疗前有出血症状，包括瘀点、自发性和外伤性瘀斑、牙龈出血和鼻出血。基线血小板计数中位数为17,000/mm³（范围3-61,000/mm³）。输注IVIG后，所有患者在第8天时出血症状均得到缓解。IVIG治疗达到的最大血小板计数中位数为220,000/mm³（范围76-426,000/mm³）。IVIG治疗结束后，没有患者实现持续完全缓解或部分缓解。毒性反应轻微，主要为头痛和恶心。总之，性传播HIV感染和免疫性血小板减少症患者对IVIG反应良好。对于因临床出血症状或体征或因需要进行侵入性操作而需要立即但暂时提高血小板计数的HIV相关免疫性血小板减少症患者，应考虑将这种治疗作为一线治疗方法。
