Emergency surgery and refractory immune thrombocytopenic purpura. A case report.
A 35-year-old woman with post-splenectomy refractory immune thrombocytopenia presented with an acute abdominal emergency requiring laparotomy. Her platelet count was raised from 10 to 96 X 10(9)/l using a combination of high-dose methylprednisolone, plasma exchange against fresh-frozen plasma, infusion of gammaglobulin and a single mega-unit of platelets. The surgical procedure was uneventful, and with no further therapy the platelet count rose to a peak of 244 X 10(9)/l, but over the following 7 days fell back slowly to 10 X 10(9)/l, at which time the patient was discharged well.
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P
Jacobs
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L
Wood
D000006:Abdomen, Acute / Q000150:complications / Q000601:surgery*; D000328:Adult; D001803:Blood Transfusion; D005260:Female; D006801:Humans; D007154:Immune System Diseases / Q000150:complications* / Q000628:therapy; D008775:Methylprednisolone / Q000627:therapeutic use*; D010951:Plasma Exchange; D017713:Platelet Transfusion; D013921:Thrombocytopenia / Q000150:complications* / Q000628:therapy; D005719:gamma-Globulins / Q000627:therapeutic use
D005719:gamma-Globulins; D008775:Methylprednisolone