Minemura N, Matsushima T, Takagi C, Sadakata H, Tamura J, Sawamura M, Murakami H, Naruse T, Tsuchiya J
Third Department of Internal Medicine, Gunma University School of Medicine, Japan.
Acta Haematol. 1993;90(1):39-41. doi: 10.1159/000204371.
A patient with chronic idiopathic thrombocytopenic purpura (ITP), chronic disseminated intravascular coagulation (DIC) and abdominal aortic aneurysm is described. He had severe thrombocytopenia and his platelet life span was shortened (29 h). Indium 111-labeled platelet scintigraphy demonstrated an increased accumulation of radioactivity over the aneurysm and the spleen. Following preoperative heparin therapy for DIC, the platelet count remained low (10 x 10(9)/l), while the DIC improved. Because of the elevated platelet-associated IgG, we considered that the patient had complicated chronic ITP. After intravenous immunoglobulin therapy, his platelet count increased. The aneurysm was successfully replaced with an artificial Y-graft vessel and a splenectomy was performed at the same time. The platelet count was maintained at about 60 x 10(9)/l after the operation and the patient is quite well now.
本文描述了一位患有慢性特发性血小板减少性紫癜（ITP）、慢性弥散性血管内凝血（DIC）和腹主动脉瘤的患者。他有严重的血小板减少症，血小板寿命缩短（29小时）。铟111标记的血小板闪烁扫描显示动脉瘤和脾脏部位放射性积聚增加。在术前针对DIC进行肝素治疗后，血小板计数仍维持在低水平（10×10⁹/L），而DIC有所改善。由于血小板相关IgG升高，我们认为该患者合并了慢性ITP。静脉注射免疫球蛋白治疗后，他的血小板计数有所增加。成功用人造Y形移植血管替换了动脉瘤，并同时进行了脾切除术。术后血小板计数维持在约60×10⁹/L，患者目前情况良好。
