Progressive systemic sclerosis complicated with immune thrombocytopenia during D-penicillamine therapy.
Immune thrombocytopenia is a rare complication of progressive systemic sclerosis (PSS). A 47-year-old female with PSS treated with D-penicillamine developed immune thrombocytopenia, which promptly responded to prednisolone and withdrawal of D-penicillamine. Platelet-associated IgG was elevated and the bone marrow megakaryocyte count was normal. There was an inverse relationship between the level of platelet-associated IgG and the platelet count. A lymphocyte stimulation test sensitized by D-penicillamine was positive. The present case suggests that immune thrombocytopenia may be regarded as one of the D-penicillamine-related immune abnormalities. To our knowledge, its association with PSS has never been reported.
Natsuda
H
H
Department of Internal Medicine, University of Tsukuba, Japan.
Matsui
Y
Y
Sakauchi
M
M
Kato
S
S
Takemura
H
H
Suzuki
H
H
Kono
I
I
Yamane
K
K
Kashiwagi
H
H
D001792:Blood Platelets / Q000276:immunology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008875:Middle Aged; D010396:Penicillamine / Q000009:adverse effects* / Q000276:immunology; D012595:Scleroderma, Systemic / Q000150:complications* / Q000188:drug therapy; D013921:Thrombocytopenia / Q000139:chemically induced / Q000209:etiology* / Q000276:immunology
D007074:Immunoglobulin G; D010396:Penicillamine