Transurethral ureterolithotripsy and extracorporeal shock wave lithotripsy in patients with idiopathic thrombocytopenic purpura.
Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disease defined by a low platelet count secondary to accelerated platelet destruction by anti-platelet antibodies. The resulting bleeding diathesis can present a therapeutic dilemma. We have treated two cases of ITP in which ureteral stones were successfully extracted by transurethral ureterolithotripsy (TUL) and extracorporeal shock wave lithotripsy (ESWL) after high-dose gamma-globulin therapy. The first case was in a 52-year-old woman and the second case was in a 65-year-old woman. Intravenous pyelography revealed a left ureteral stone in the first case and bilateral ureteral stones in the second case. High-dose gamma-globulin therapy and platelet transfusion elevated their platelet counts to safe levels; TUL and ESWL were then performed successfully with no bleeding complications. This is the first case report of ITP being treated by ESWL after high-dose gamma-globulin therapy. High-dose gamma-globulin therapy effectively provides adequate platelet counts for surgical treatment in patients with ITP.
Tsuboi
Toshiki
T
Department of Urology, Kitasato University School of Medicine.
Fujita
Tetsuo
T
Maru
Norio
N
Matsumoto
Kazumasa
K
Iwamura
Masatsugu
M
Baba
Shiro
S
D000368:Aged; D005260:Female; D006470:Hemorrhage / Q000517:prevention & control; D006801:Humans; D008096:Lithotripsy / Q000379:methods*; D008875:Middle Aged; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications* / Q000188:drug therapy; D014514:Ureteral Calculi / Q000628:therapy*; D005719:gamma-Globulins / Q000008:administration & dosage
D005719:gamma-Globulins