[Vincristine played a pivotal role in hematological remission of thrombotic thrombocytopenic purpura (T.T.P.)].
A case of thrombotic thrombocytopenic purpura (TTP), in which vincristine (VCR) administration played a pivotal role in achieving the hematological remission, is presented. A 40-year-old woman with a chief complaint of purpura was transferred for detailed examination of thrombocytopenia. The presence of hemolytic anemia, schistocytosis, febrile clinical course, renal dysfunction and neurological abnormalities made the basis of a diagnosis of TTP. Twelve courses of consecutive plasma exchange and plasma infusion, which amounted to a total of 120l of fresh frozen plasma, were performed without obvious hematological improvement. Therefore, VCR (2 mg) was infused in addition to the plasma exchange. Three days later, platelets responded remarkably. After 10 days of hematological improvement, relapse occurred. VCR was reinfused. However, the second VCR infusion alone was not able to elevate platelets. With concomitant use of significant amounts of plasma, the platelet count responded gradually. Hematological remission was obtained and has continued until now. The exact role of VCR for TTP is still unknown; however, VCR is suggested to be effective for TTP as in the case presented here.
Imai
N
N
Division of Internal Medicine, Kansai-Rosai Hospital.
Miyazaki
M
M
Okada
M
M
Urase
Y
Y
Ohhata
S
S
Matsumoto
M
M
Hattori
K
K
Kubori
S
S
D000328:Adult; D005260:Female; D006801:Humans; D010976:Platelet Count / Q000187:drug effects; D011697:Purpura, Thrombotic Thrombocytopenic / Q000097:blood / Q000188:drug therapy*; D012074:Remission Induction; D014750:Vincristine / Q000627:therapeutic use*
D014750:Vincristine