Kelton J G
JAMA. 1981;245(4):369-70.
Many patients with immune thrombocytopenia require splenectomy to achieve remission. They are therefore at risk for postsplenectomy septicemia and should receive vaccination against Streptococcus pneumoniae. In experiment situations, antigens contained within this vaccine cell initiate a polyclonal B-lymphocyte activation and increased production of specific and nonspecific antibodies. In certain animal models, a polyclonal B-lymphocyte stimulatory response can trigger an autoimmune disorder. Two patients with immune thrombocytopenia had relapses of their immune thrombocytopenia after the administration of pneumococcal and influenza vaccines. These observations suggest that patients with a history of immune thrombocytopenia should be monitored after vaccination.
许多免疫性血小板减少症患者需要进行脾切除术以实现缓解。因此，他们有脾切除术后败血症的风险，应接种肺炎链球菌疫苗。在实验情况下，这种疫苗细胞内所含的抗原会引发多克隆B淋巴细胞活化，并增加特异性和非特异性抗体的产生。在某些动物模型中，多克隆B淋巴细胞刺激反应可引发自身免疫性疾病。两名免疫性血小板减少症患者在接种肺炎球菌疫苗和流感疫苗后，免疫性血小板减少症复发。这些观察结果表明，有免疫性血小板减少症病史的患者在接种疫苗后应接受监测。
