Lightsey A L, McMillan R, Koenig H M, Schanberger J E, Lang J E
J Pediatr. 1976 Mar;88(3):415-8.
We studied two boys, 9 and 10 years old, respectively, who underwent splenectomy eight months and six weeks after initially presenting as "typical" cases of childhood ITP. Splenic leukocytes from each child were cultured and net synthesis rates of IgG determined. Splenic synthesis rates of IgG were five-and sevenfold greater, respectively, than in spleens of control subjects. A significant portion of the splenic culture-produced IgG from each patient demonstrated specificity for homologous and autologous platelets. Synthesis rates of IgG were determined on serial cultures of bone marrow cells from the 10-year-old boy who failed to respond to splenectomy. His initial marrow synthesis rate of IgG was five times greater than mean control values. His synthesis rate of IgG in marrow decreased to the control range in association with immunosuppressive therapy and intesive platelet transfusions. These data suggest that (1) the spleen was a production site of platelet-binding IgG in the two children, and (2) the bone marrow may have been an additional site of production in our second patient.
我们研究了两名分别为9岁和10岁的男孩，他们最初表现为儿童特发性血小板减少性紫癜（ITP）的“典型”病例，分别在8个月和6周后接受了脾切除术。对每个孩子的脾白细胞进行培养，并测定IgG的净合成率。每个孩子的脾脏IgG合成率分别比对照受试者的脾脏高5倍和7倍。来自每位患者的脾脏培养产生的IgG的很大一部分表现出对同源和自体血小板的特异性。对一名脾切除术后无反应的10岁男孩的骨髓细胞进行连续培养，测定其IgG合成率。他最初的骨髓IgG合成率比平均对照值高5倍。随着免疫抑制治疗和强化血小板输注，他骨髓中的IgG合成率降至对照范围。这些数据表明：（1）脾脏是这两名儿童中血小板结合IgG的产生部位，（2）骨髓可能是我们第二名患者中IgG的另一个产生部位。
