Splenectomy outcome in a hemophilic patient with HIV-related immune thrombocytopenia.
We report the case of a young hemophilic patient with antibodies against the human immunodeficiency virus (HIV) who was affected by immune thrombocytopenic purpura (ITP). This condition did not respond to pharmacological therapy with steroids and alpha-2b-r-IFN, and the patient was splenectomized. Immune status evaluation was performed before and after surgery and during follow-up with CD4-CD8 monoclonal antibodies and cytofluorimetric analysis in order to explore possible correlations between splenectomy and the cytologic immune regulatory system. Splenectomy resulted in a resolution of ITP with consequent disappearance of the hemorrhagic diathesis related to thrombocytopenia. Moreover, at 30 months from splenectomy the patient is still in remission, his CD4 count is not decreased, and no progression to AIDS has been evidenced. These aspects are analyzed and briefly discussed.
Dragoni
F
F
Dipartimento di Biopatologia Umana, Università La Sapienza, Roma, Italy.
Arcieri
R
R
Chistolini
A
A
De Sanctis
V
V
Pasqualetti
D
D
Mazzucconi
M G
MG
D000328:Adult; D015496:CD4-Positive T-Lymphocytes; D003131:Combined Modality Therapy; D015658:HIV Infections / Q000150:complications*; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D007958:Leukocyte Count; D008297:Male; D010976:Platelet Count; D011241:Prednisone / Q000627:therapeutic use; D011696:Purpura, Thrombocytopenic / Q000150:complications / Q000601:surgery* / Q000628:therapy; D011994:Recombinant Proteins; D012074:Remission Induction; D013156:Splenectomy
D007155:Immunologic Factors; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011241:Prednisone