[Infection-induced transient increase in the platelet count, and a transient remission of thrombocytopenia with high-dose intravenous gammaglobulin therapy during intercurrent pneumonia in chronic idiopathic thrombocytopenic purpura].
A patient with chronic idiopathic thrombocytopenic purpura (ITP), who had a transient increase in platelet count during infectious episodes, and had a transient remission of thrombocytopenia with administration of high-dose intravenous gammaglobulin during intercurrent pneumonia was described. A 64-year-old Japanese woman with a 12-year history of chronic ITP was refractory to steroids and azathioprine, and the platelet count was constantly less than 10 x 10(9)/l. During both acute upper respiratory infections and chronic cystitis due to E. coli, the platelet count transiently increased to more than 40 x 10(9)/l. High-dose intravenous gammaglobulin therapy successfully induced a remarkable increase in the platelet count, which persisted for 3 months, when gammaglobulin was administered during the intercurrent pneumonia. The bleeding tendency disappeared and transient remission of ITP was obtained. In contrast, the clinical efficacy of high-dose intravenous gammaglobulin proved to be only transient and slight, when administered before the onset of pneumonia or after recovery from pneumonia. These phenomena may suggest that high-dose gammaglobulin may enhance some positive mechanisms related to platelet increment in infectious diseases accompanied with chronic ITP.
Katoh
M
M
First Department of Internal Medicine, Toho University, Tokyo.
Ishikawa
I
I
Umeda
M
M
Tsukahara
T
T
D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use*; D007239:Infections / Q000150:complications / Q000628:therapy*; D008875:Middle Aged; D010976:Platelet Count; D011014:Pneumonia / Q000150:complications / Q000628:therapy*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood* / Q000150:complications; D012074:Remission Induction; D013921:Thrombocytopenia / Q000097:blood / Q000628:therapy*
D016756:Immunoglobulins, Intravenous