Branda R F, Tate D Y, McCullough J J, Jacob H S
Lancet. 1978 Apr 1;1(8066):688-90. doi: 10.1016/s0140-6736(78)90800-0.
Rapid plasma exchange in a young man with idiopathic (autoimmune) thrombocytopenic purpura and life-threatening haemorrhage acutely increased the platelet-count and enhanced haemostasis. The patient had not responded to steroids, and massive intra-abdominal bleeding had developed after splenectomy, despite numerous platelet transfusions. After plasma exchange, his haemoglobin concentration became normal without further transfusion and his abdominal girth decreased. Therefore emergency reoperation because of intra-abdominal bleeding was no longer required. A cumulative-sums plot of his platelet-count confirmed that plasmapheresis on 2 occasions was followed by a pronounced rise in mean platelet-count. Neither prednisone nor vincristine therapy altered the slope of the plot. The high initial anti-platelet antibody concentration in this patient fell after plasma exchange. These findings indicate that plasmapheresis accelerated clearance of circulating anti-platelet factors in fulminant idiopathic thrombocytopenic purpura.
一名患有特发性（自身免疫性）血小板减少性紫癜且有危及生命的出血症状的年轻男子，进行快速血浆置换后血小板计数急剧增加，止血功能增强。该患者对类固醇治疗无反应，脾切除术后尽管多次输注血小板仍发生了大量腹腔内出血。血浆置换后，他的血红蛋白浓度恢复正常，无需进一步输血，腹围减小。因此不再需要因腹腔内出血而进行紧急再次手术。他血小板计数的累积和图证实，两次进行血浆置换后平均血小板计数显著上升。泼尼松和长春新碱治疗均未改变该图的斜率。该患者最初较高的抗血小板抗体浓度在血浆置换后下降。这些发现表明，血浆置换加速了暴发性特发性血小板减少性紫癜中循环抗血小板因子的清除。
