Pollak A N, Janinis J, Green D
Department of Medicine, Northwestern University Medical School, Chicago, IL.
Arch Intern Med. 1988 Mar;148(3):695-7.
High-dose intravenous (IV) immune globulin was used to treat human immunodeficiency virus (HIV)-associated thrombocytopenia four times in three patients. The average platelet count at initiation of therapy was 12 x 10(9)/L (12 x 10(3)/mm3), and the platelet count after therapy was 159 x 10(9)/L (159 x 10(3)/mm3), giving a mean increase of 147 x 10(9)/L (147 x 10(3)/mm3) (1225%). The conditions of two of these patients were refractory to corticosteroids, but giving IV immune globulin along with steroids appeared to enhance the response to IV immune globulin. A review of the literature revealed that 53 (88%) of 60 patients with HIV-associated thrombocytopenia responded to IV immune globulin with platelet counts greater than 50 x 10(9)/L (50 x 10(3)/mm3). We conclude that IV immune globulin therapy achieves transient elevations in platelet counts to levels that control bleeding and permit surgery in patients with severe, HIV-associated thrombocytopenia.
高剂量静脉注射免疫球蛋白被用于治疗3例患者的人类免疫缺陷病毒（HIV）相关血小板减少症，共4次。治疗开始时的平均血小板计数为12×10⁹/L（12×10³/mm³），治疗后的血小板计数为159×10⁹/L（159×10³/mm³），平均增加147×10⁹/L（147×10³/mm³）（1225%）。其中2例患者对皮质类固醇难治，但联合使用静脉注射免疫球蛋白和类固醇似乎增强了对静脉注射免疫球蛋白的反应。文献回顾显示，60例HIV相关血小板减少症患者中有53例（88%）对静脉注射免疫球蛋白有反应，血小板计数大于50×10⁹/L（50×10³/mm³）。我们得出结论，静脉注射免疫球蛋白治疗可使严重HIV相关血小板减少症患者的血小板计数短暂升高至控制出血并允许手术的水平。
