title: Progressive systemic sclerosis complicated with immune thrombocytopenia during D-penicillamine therapy.
abstract: 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.
authors.affiliation: Department of Internal Medicine, University of Tsukuba, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Natsuda
authors.forename: Y
authors.initials: Y
authors.lastname: Matsui
authors.forename: M
authors.initials: M
authors.lastname: Sakauchi
authors.forename: S
authors.initials: S
authors.lastname: Kato
authors.forename: H
authors.initials: H
authors.lastname: Takemura
authors.forename: H
authors.initials: H
authors.lastname: Suzuki
authors.forename: I
authors.initials: I
authors.lastname: Kono
authors.forename: K
authors.initials: K
authors.lastname: Yamane
authors.forename: H
authors.initials: H
authors.lastname: Kashiwagi
mesh_terms: 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
chemical_list: D007074:Immunoglobulin G; D010396:Penicillamine