Coronary artery bypass grafting in chronic immune-mediated thrombocytopenic purpura: preoperative treatment with intravenous immunoglobulin and corticosteroids.
A 64-year-old male with chronic immune-mediated thrombocytopenic purpura (cITP) underwent three-vessel coronary artery bypass grafting after preoperative treatment with steroids and intravenous immunoglobulin with no prophylactic splenectomy performed. On the morning of surgery the platelet count was 110 x 10(3)/mm3, up from an initial 18 x 10(3)/mm3. The patient tolerated the procedure well, with no intraoperative or postoperative complications. This case demonstrates that with appropriate perioperative management, patients with cITP can safely undergo major cardiac surgery.
Hofmeister
E P
EP
Aviation Medicine, Marine Corps Base Hawaii, Kaneohe, 96744, USA.
D000787:Angina Pectoris / Q000150:complications; D001026:Coronary Artery Bypass; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use*; D011696:Purpura, Thrombocytopenic / Q000150:complications*; D016896:Treatment Outcome
D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous; D011241:Prednisone