Immunoadsorption method using immunoglobulin Adsopak in adult cases with ITP resistant to splenectomy and other medical therapies.
BACKGROUND
Despite all medical therapies and splenectomy performed, severe life-threatening thrombocytopenia persists in many adult patients.


OBJECTIVE
To evaluate the efficiency of Immunoglobulin Adsopak immunoadsorption method in eliminating circulating immunocomplexes and IgG from plasma in these cases.


METHODS
The method of POCARD Ig-Adsopak Wide Spectrum was applied to four cases with severe thrombocytopenia (< or =20.000/microL) by treating with a daily plasma of 0.25-2 L for 6 days. Platelet counts were recorded at the beginning and during administration of the method. For long-term effects, the cases were called for monthly controls during which platelet counts were measured.


RESULTS
Platelet counts of four cases started to increase on average as of the first day. On Day 11, the platelet count reached 50.000/microL. On the following days (Day 17), platelet count was recorded as 90.000/microL. Cases were followed up for a mean of 2 years. At the end of 2 years, mean platelet count of the patients was 210.000 (175.000-265.000) microL.


CONCLUSIONS
In adult cases who do not respond to surgical and medical therapy, including splenectomy, the results obtained from the therapy using the method of Immunoadsorption with Immunoglobulin Adsopak are promising both in short and long-term follow up.
Bilgir
Oktay
O
Izmir Education and Research Hospital, 2nd Clinic of Internal Medicine, 35380 Izmir, Turkey. obilgir2001@yahoo.com
Bilgir
Ferda
F
Calan
Mehmet
M
Kebapcilar
Levent
L
Kula
Esin
E
D000328:Adult; D000368:Aged; D000818:Animals; D000910:Antibodies, Heterophile / Q000276:immunology; D000936:Antigen-Antibody Complex / Q000097:blood* / Q000276:immunology; D001323:Autoantibodies / Q000097:blood; D003131:Combined Modality Therapy; D004351:Drug Resistance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D007163:Immunosorbent Techniques / Q000295:instrumentation; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy / Q000276:immunology / Q000601:surgery / Q000628:therapy*; D012685:Sepharose / Q000031:analogs & derivatives; D012756:Sheep; D013156:Splenectomy; D055815:Young Adult
D000910:Antibodies, Heterophile; D000936:Antigen-Antibody Complex; D001323:Autoantibodies; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; C035771:Sepharose CL 4B; D012685:Sepharose