Saito K, Ishiyama T, Hashimoto M, Osawa H, Koike M, Sugimoto M, Horie S, Wakabayashi Y, Hirose S
Department of Internal Medicine, Juntendo University School of Medicine, Tokyo, Japan.
Rinsho Ketsueki. 1990 Jan;31(1):52-6.
A 37 year-old female was admitted to our hospital because of hypermenorrhea, prolonged bleeding time, thrombocytopenia and the diagnosis of idiopathic thrombocytopenic purpura (ITP) was made. Though activated partial thromboplastin time (APTT) was markedly prolonged, her coagulation factors were within normal ranges. Activities of the circulating lupus anticoagulant (LAC) was suggested. Kaolin clotting time of the platelet poor plasma was used as a sensitive screening test using the mixture of normal and patient's plasma for the detect of LAC. As a result, LAC positive pattern was observed. The treatment with high-dose gammaglobulin brought out a transient increase of the platelet count, but the prolongation of APTT was not corrected. Both the platelet count and the prolongation of APTT were significantly improved after the treatment with betamethasone.
一名37岁女性因月经过多、出血时间延长、血小板减少入院，诊断为特发性血小板减少性紫癜（ITP）。尽管活化部分凝血活酶时间（APTT）明显延长，但她的凝血因子在正常范围内。提示存在循环狼疮抗凝物（LAC）活性。用正常血浆和患者血浆混合进行血小板贫乏血浆的高岭土凝血时间检测作为检测LAC的敏感筛查试验。结果，观察到LAC阳性模式。大剂量γ球蛋白治疗使血小板计数短暂升高，但APTT延长未得到纠正。地塞米松治疗后，血小板计数和APTT延长均得到显著改善。
