[Recurrence of immunologic thrombocytopenic purpura due to hypertrophy of retained accessory spleens].
Idiopathic thrombocytopenic purpura is an autoimmune disease in which macrophages of reticuloendothelial system, mainly in the spleen, remove platelets covered by autoantibodies from circulation. By removing the spleen 60-80% of patients are cured. Partial remission is achieved in 10-20% cases. Very few patients do not react on splenectomy. Recurrency of idiopathic thrombocytopenic purpura in a splenectomized patient after already achieved complete remission, may be caused by hypertrophy of one or more of the retained accessory spleens. We present 3 patients, 41, 23 and 44 year old, in whom splenectomy for ITP had been performed 10, 3 and 11 years earlier. After full remission which lasted 10, 2.5 and 10.5 years a full recurrency of ITP took place with signs of severe thrombocytopenia and haemorrhagic syndrome. Using ultrasonography, computed tomography and scintigraphy accessory spleen/s, were discovered. By their removal, a full remission was achieved in all 3 patients, but full favorable effect appeared approximately three months after surgery during which period additional steroid therapy was necessary.
Colović
R
R
Institut za bolesti digestivnog sistema KCS, I Hirurska klinika, Beograd.
Popović
M
M
Grubor
N
N
Colović
M
M
Bosković
D
D
D000328:Adult; D005260:Female; D006801:Humans; D006984:Hypertrophy; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000601:surgery*; D012008:Recurrence; D013154:Spleen / Q000002:abnormalities* / Q000473:pathology; D013156:Splenectomy