[Refractory immune thrombocytopenic purpura accompanied with avascular necrosis of femoral head receiving the combination of high dose immunoglobulin therapy followed by platelet transfusion could successfully be managed to undergo surgery].
A 31 year-old male with refractory immune thrombocytopenic purpura (ITP) was accompanied with avascular necrosis of the femoral head on both sides, refractory to the following conventional therapies: high dose immunoglobulin (IgG) therapy, splenectomy, vinblastin slow infusion; maintaining a platelet count less than 20 x 10(3)/microliters. He subsequently tried the combination of high dose IgG therapy with platelet transfusion from two single donors, which successfully increased the platelet count to more than 50 x 10(3)/microliters for as long as 9 days. Compared to this method, platelet transfusion alone without IgG infusion failed to maintain an increase in the platelet count. These results suggest that high dose IgG may affect transfused-platelet removal in ITP. Management by the combination method enabled him to undergo surgery twice and he was able to walk with a stick six months later.
Katoh
M
M
First Department of Internal Medicine, Toho University.
Shikoshi
K
K
Kosuge
T
T
Umeda
M
M
Tsukahara
T
T
D000328:Adult; D003131:Combined Modality Therapy; D005271:Femur Head Necrosis / Q000601:surgery*; D006801:Humans; D008297:Male; D017713:Platelet Transfusion; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications / Q000628:therapy*; D005719:gamma-Globulins / Q000008:administration & dosage*
D005719:gamma-Globulins