[Splenectomy in the treatment of idiopathic thrombocytopenic purpura].
During the period from 1985 till 1988, 48 patients with this disease were treated; in 28 patients (58%) conservatively treated with pronisone, immunated with thrombocytes that possessed onkovin, a remission had been achieved. In 20 patients (41%), following an unsuccessful conservative treatment, splenectomy was performed; of whom 14 were female (70%) and 6 were male (30%), with an average age of 36 years (between 20-52 years). Prior to that they were conservatively treated from 1-15 years (on the average 4.7 years). Despite the failure of the conservative treatment, an indication for splenectomy was the high doses of corticosteroids needed, as well as the appearance of serious unwanted effects of this therapy (ulcer, steroid diabetes, hypertension, osteoporosis), also the unsuccessful treatment with thrombocytes which carried onkovin. There was no surgical lethality; 2 female patients developed deep ileofemoral thrombophlebitis of the left leg, one 7 days, and the other 1 1/2 months following the surgery, and after an adnexoparametritis of the left side. Following intensive anticoagulant and fibrinolytic therapy, a complete recanalization of the vein was achieved in both female patients, without any signs of a postphlebitis syndrome. One patient who had previously been treated for 15 years with high doses of pronisone and persistently refused surgery during this period, followed splenectomy developed miliary tuberculosis which ended lethally 2 months following the splenectomy. In 14 patients (73.6%) a complete remission was attained. In 2 patients (10.5%) the number of thrombocytes was not necessary.(ABSTRACT TRUNCATED AT 250 WORDS)
Colović
M
M
Colović
R
R
Tomasević
I R
IR
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011696:Purpura, Thrombocytopenic / Q000601:surgery*; D013156:Splenectomy
Splenektomija u lecenju idiopatske trombocitopenijske purpure.