Kocaeli University, Medical Faculty.
J Pediatr Hematol Oncol. 2023 Nov 1;45(8):e988-e992. doi: 10.1097/MPH.0000000000002718. Epub 2023 Jul 13.
Managing intracranial bleeding in patients with refractory immune thrombocytopenia is difficult.
A 16-year-old female refractory to prednisolone, intravenous immunoglobulin, eltrombopag, and cyclosporin exhibited heavy menstrual bleeding requiring packed red blood cell transfusions. Autoimmune antibodies were detected, indicating of lupus, and hydroxychloroquine sulfate was administered. In month 6 following the diagnosis, the patient presented with intracranial hemorrhage. Splenic artery embolization promptly increased platelets, and the patient was discharged without any neurological sequela. In month 5 of embolization, the patient's platelet count continued to exceed 300,000/µL without any medical treatment.
Splenic artery embolization is a life-saving procedure in refractory immune thrombocytopenia.
治疗难治性免疫性血小板减少症患者的颅内出血较为困难。
一名 16 岁女性对泼尼松龙、静脉注射免疫球蛋白、艾曲泊帕和环孢素均无反应，表现为月经过多，需要输注红细胞。自身免疫抗体检测提示狼疮，给予硫酸羟氯喹治疗。诊断后第 6 个月，患者出现颅内出血。脾动脉栓塞术迅速提高了血小板计数，患者出院时无任何神经后遗症。栓塞术后第 5 个月，患者的血小板计数持续超过 300000/µL，未进行任何药物治疗。
脾动脉栓塞术是治疗难治性免疫性血小板减少症患者颅内出血的一种救命方法。
