长春新碱用于妊娠合并难治性自身免疫性血小板减少性紫癜：一例报告

Vincristine for refractory autoimmune thrombocytopenic purpura in pregnancy. A case report.

作者信息

Gross Z, Rodriguez J J, Stalnaker B L

机构信息

Department of Obstetrics and Gynecology, University of Florida College of Medicine, Pensacola 32503, USA.

出版信息

J Reprod Med. 1995 Oct;40(10):739-42.

PMID:8551481

Abstract

BACKGROUND

Autoimmune thrombocytopenic purpura is a common disease during pregnancy. Newborns of affected mothers commonly develop thrombocytopenia. Standard therapy consists of corticosteroids, hyperimmune gamma globulin and splenectomy.

CASE

Severe autoimmune thrombocytopenic purpura was diagnosed in a 22-year-old woman, gravida 2, para 1, at 28 weeks' gestation. A sufficient response was obtained after vincristine was added to the treatment with corticosteroids, hyperimmune gamma globulin and danazole. A male infant weighing 2,545 g was delivered by cesarean section at 33.5 weeks' gestation. There were no maternal or fetal complications except for severe newborn thrombocytopenia, which resolved with medical therapy.

CONCLUSION

Vincristine has been used in all trimesters of pregnancy, with favorable outcomes in most cases. This is the first reported case of successful vincristine treatment for autoimmune thrombocytopenic purpura in pregnancy. Vincristine, when carefully used, offers an option for unusually refractory cases of autoimmune thrombocytopenic purpura before delivery.

摘要

背景

自身免疫性血小板减少性紫癜是妊娠期常见疾病。患病母亲的新生儿通常会出现血小板减少。标准治疗包括使用皮质类固醇、高免疫球蛋白和脾切除术。

病例

一名22岁、孕2产1的女性在妊娠28周时被诊断为重度自身免疫性血小板减少性紫癜。在用皮质类固醇、高免疫球蛋白和达那唑治疗的基础上加用长春新碱后获得了充分的疗效。在妊娠33.5周时通过剖宫产分娩出一名体重2545克的男婴。除了严重的新生儿血小板减少外，无母体或胎儿并发症，该并发症经药物治疗后得到缓解。