Heer M, Pirovino M, Bühler H, Altorfer J, Schmid M, von Felten A
Hepatogastroenterology. 1983 Feb;30(1):12-4.
A 25-year-old heroin-addict had four episodes of acute hepatitis, each of them associated with thrombocytopenia. Serologically, hepatitis A and B as well as cytomegalo- or Epstein-Barr virus infections were excluded. High levels of circulating immune complexes and antibodies reacting with aminophospholipids, a component of both liver cell and platelet membranes, were detected during the last two attacks of hepatitis, but were absent during remission. Platelet-associated antibodies of the IgM class paralleled the 'anti-phospholipid' antibodies during the fourth attack. These findings demonstrate an immunological basis of the thrombocytopenia and point to the possibility of a direct association between liver cell injury and peripheral platelet destruction in certain patients.
一名25岁的海洛因成瘾者出现了4次急性肝炎发作，每次发作都伴有血小板减少。血清学检查排除了甲型和乙型肝炎以及巨细胞病毒或EB病毒感染。在最后两次肝炎发作期间检测到高水平的循环免疫复合物以及与氨基磷脂（肝细胞和血小板膜的一种成分）发生反应的抗体，但在缓解期则不存在。在第四次发作期间，IgM类血小板相关抗体与“抗磷脂”抗体平行。这些发现证明了血小板减少的免疫学基础，并指出在某些患者中肝细胞损伤与外周血小板破坏之间可能存在直接关联。
