Katoh M, Shikoshi K, Kosuge T, Umeda M, Tsukahara T
First Department of Internal Medicine, Toho University.
Rinsho Ketsueki. 1994 Aug;35(8):798-800.
A 31 year-old male with refractory immune thrombocytopenic purpura (ITP) was accompanied with avascular necrosis of the femoral head on both sides, refractory to the following conventional therapies: high dose immunoglobulin (IgG) therapy, splenectomy, vinblastin slow infusion; maintaining a platelet count less than 20 x 10(3)/microliters. He subsequently tried the combination of high dose IgG therapy with platelet transfusion from two single donors, which successfully increased the platelet count to more than 50 x 10(3)/microliters for as long as 9 days. Compared to this method, platelet transfusion alone without IgG infusion failed to maintain an increase in the platelet count. These results suggest that high dose IgG may affect transfused-platelet removal in ITP. Management by the combination method enabled him to undergo surgery twice and he was able to walk with a stick six months later.
一名31岁患有难治性免疫性血小板减少性紫癜（ITP）的男性患者双侧股骨头出现无菌性坏死，对以下传统治疗方法无效：大剂量免疫球蛋白（IgG）治疗、脾切除术、长春花碱缓慢输注；血小板计数持续低于20×10³/微升。随后，他尝试了大剂量IgG治疗与来自两名单采供血者的血小板输注相结合的方法，该方法成功地使血小板计数在长达9天的时间内升至50×10³/微升以上。与该方法相比，单纯血小板输注而不输注IgG未能维持血小板计数的升高。这些结果表明，大剂量IgG可能会影响ITP患者输注血小板的清除。采用联合治疗方法使他能够接受两次手术，6个月后他能够拄着拐杖行走。
