title: Successful perioperative management of a patient with idiopathic thrombocytopenic purpura undergoing emergent appendectomy: Report of a case.
abstract: BACKGROUND
  Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disease characterized by a low platelet count and normal bone marrow. Patients with ITP undergoing surgery are thought to have increased risk for postoperative complications because of their thrombocytopenia.
  
  
  METHODS
  we report the case of a 66-year-old woman with ITP who required an emergency operation for acute appendicitis associated with disseminated intravascular coagulation. Preoperative therapy consisted of platelet transfusions only, and intraoperative hemostasis was achieved. Postoperatively, high-dose intravenous immunoglobulin (IVIg) therapy led to an increased, stable, and adequate platelet count and good hemostasis.
  
  
  CONCLUSIONS
  The outcome of this case suggests that IVIg therapy is not always required for preoperative management of patients with.
  
  
  CONCLUSIONS
  IVIg therapy may be useful for postoperative management after emergency surgery.
authors: Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan; Department of Surgery, Nakatsu Municipal Hospital, 173 Shimoikenaga, Nakatsu, Oita 871-8511, Japan. Electronic address: toyomasu@med.gunma-u.ac.jp.
authors: Yoshitaka
authors: Y
authors: Toyomasu
authors: Rinshun
authors: R
authors: Shimabukuro
authors: Hatsuo
authors: H
authors: Moriyama
authors: Daihiko
authors: D
authors: Eguchi
authors: Koichi
authors: K
authors: Ishikawa
authors: Fumiaki
authors: F
authors: Kishihara
authors: Yasurou
authors: Y
authors: Fukuyama
authors: Takashi
authors: T
authors: Matsumata
authors: Erito
authors: E
authors: Mochiki
authors: Hiroyuki
authors: H
authors: Kuwano
keywords: CRP; CT; DIC; Disseminated intravascular coagulation; FDP; ITP; IVIg; Operation; PT/INR; Platelet transfusion; WBC; c-reactive protein; computed tomography; disseminated intravascular coagulation; fibrin degradation products; idiopathic thrombocytopenic purpura; intravenous immunoglobulin; prothrombin time/international normalized ration; white blood cell
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