Morris L, Distenfeld A, Amorosi E, Karpatkin S
Ann Intern Med. 1982 Jun;96(6 Pt 1):714-7. doi: 10.7326/0003-4819-96-6-714.
Since November 1980 we have diagnosed 11 cases of severe autoimmune thrombocytopenic purpura in homosexual men; their mean platelet count (+/- SE) was 16 000 +/- 3000/mm3. All patients have been sexually active with multiple partners and exposed to numerous viruses and drugs. During this period, we also have diagnosed 20 cases of classic autoimmune thrombocytopenic purpura in heterosexual persons, with a normal women to men ratio of 3:1. Eight of nine homosexual patients had elevated platelet IgG compared with normal values in eight of 10 homosexual control subjects having normal hemograms (p less than 0.01). All responded moderately or completely to steroids. The three patients who had splenectomy had excellent responses. Four of five patients had a decreased helper/suppressor T cell ratio compared to healthy controls (p less than 0.001). Circulating immune complexes and total gamma globulin levels were elevated and lymphocytes relatively decreased in homosexual patients compared with homosexual controls (p less than 0.05). Thus, some sexually-active homosexual men seem to have an increased incidence of an immune regulation disorder directed against platelets.
自1980年11月以来，我们已诊断出11例男同性恋者患有严重自身免疫性血小板减少性紫癜；他们的平均血小板计数（±标准误）为16000±3000/mm³。所有患者都有多个性伴侣且有多种病毒和药物接触史。在此期间，我们还诊断出20例异性恋者患有典型自身免疫性血小板减少性紫癜，男女比例正常，为3:1。9例男同性恋患者中有8例血小板IgG高于正常血细胞计数的10例男同性恋对照者中的8例（p<0.01）。所有患者对类固醇治疗有中度或完全反应。3例行脾切除术的患者反应良好。5例患者中有4例与健康对照相比辅助性/抑制性T细胞比值降低（p<0.001）。与男同性恋对照者相比，男同性恋患者的循环免疫复合物和总γ球蛋白水平升高，淋巴细胞相对减少（p<0.05）。因此，一些性活跃的男同性恋者似乎针对血小板的免疫调节紊乱发生率增加。
