Brink S, Hesseling P B, Amadhila S, Visser H S
S Afr Med J. 1981 Jun 6;59(24):855-8.
A prospective study was undertaken to assess the nature, incidence and natural history of platelet antibodies in patients with immune thrombocytopenic purpura (ITP) and patients with onyalai, using an immunofluorescent technique. Twelve patients under 14 years old and 11 patients 14-75 years old with ITP, and 24 patients with onyalai were studied. Alternate younger patients were treated with corticosteroids. Ten of the 12 children with ITP had IgG platelet antibodies in their serum, which disappeared as the platelet count recovered. Steroid therapy did not change the course of the disease or the antibody response. Of the 24 patients with onyalai, 23 had IgG antibodies and 18 had IgM antibodies, which were still present after 14 days and unrelated to their rise in platelet count. Steroid therapy did not affect the platelet count or the antibody titre. The difference in immune response of ITP and onyalai points to a difference in aetiology. The clinical presence of IgM antibodies in onyalai fits the hypothesis that a toxin, possibly acting as a hapten, is responsible for this form of thrombocytopenia.
采用免疫荧光技术进行了一项前瞻性研究，以评估免疫性血小板减少性紫癜（ITP）患者和奥尼亚莱患者血小板抗体的性质、发生率和自然病程。研究了12名14岁以下的ITP患者、11名14 - 75岁的ITP患者以及24名奥尼亚莱患者。年龄较小的患者交替接受皮质类固醇治疗。12名ITP儿童患者中有10名血清中存在IgG血小板抗体，随着血小板计数恢复，这些抗体消失。类固醇治疗并未改变疾病进程或抗体反应。在24名奥尼亚莱患者中，23名有IgG抗体，18名有IgM抗体，14天后这些抗体仍然存在，且与血小板计数升高无关。类固醇治疗不影响血小板计数或抗体滴度。ITP和奥尼亚莱免疫反应的差异表明病因不同。奥尼亚莱患者中IgM抗体的临床存在符合一种假设，即一种可能作为半抗原的毒素是这种血小板减少症的病因。
