高劑量免疫球蛋白對原發性血小板減少性紫斑症及經常輸血小板者之療效報告

Intravenous Gamma Globulin Treatment in Patients with Chronic Idiopathic Thrombo Cytopenic Purpura and Patients Refractory to Random-Donor Platelet Transfusions

何照洪(Chao-Hung Ho)

《Journal of Medical Sciences》 9卷3期 (1988/06) Pp. 215-221

摘要

Human immunoglobulin was administered intravenously to two different groups of patients to evaluate the increments of platelet count. Five patients with chronic idiopathic thrombocytopenic purpura (ITP) were included in group I. Their platelet count did not exceed 100,000/μl in spite of long term therapy with steroids and with/without splenectomy. After administration of Gamimune-N, all 5 patients had increments of platelet counts. The maximum increment was up to 503%, and the maximum number of increments was up to 172,000/μl. The longest period for the increment was 63 days. Three patients who needed long term platelet transfusions (PT) who had been refractory to PT were included in group 2. One hour after PT with simultaneous Gamimune-N infusion, the platelet count did increase. Forty-eight hours after PT, only 1 of the 3 patients had a platelet count ＞ 20,000/μl. The remaining 2 were ＜ 20,000/μl. Thus, Gamimune-N infusion may have a better effect in patients with chronic ITP, and a rather variable effect in patients with alloimmune platelet destruction. For ITP patients requiring operation in a few days. Gaminume-N may produce increments of platelets in a short period of time, which last longer, thus enabling to be considered a suitable drug for prevention .of severe surgical bleeding complications in patients with ITP.

關鍵字

血小板輸注 ； 原發性血小板減少性紫斑症高劑量免疫球蛋百輸注射

並列摘要

Human immunoglobulin was administered intravenously to two different groups of patients to evaluate the increments of platelet count. Five patients with chronic idiopathic thrombocytopenic purpura (ITP) were included in group I. Their platelet count did not exceed 100,000/μl in spite of long term therapy with steroids and with/without splenectomy. After administration of Gamimune-N, all 5 patients had increments of platelet counts. The maximum increment was up to 503%, and the maximum number of increments was up to 172,000/μl. The longest period for the increment was 63 days. Three patients who needed long term platelet transfusions (PT) who had been refractory to PT were included in group 2. One hour after PT with simultaneous Gamimune-N infusion, the platelet count did increase. Forty-eight hours after PT, only 1 of the 3 patients had a platelet count ＞ 20,000/μl. The remaining 2 were ＜ 20,000/μl. Thus, Gamimune-N infusion may have a better effect in patients with chronic ITP, and a rather variable effect in patients with alloimmune platelet destruction. For ITP patients requiring operation in a few days. Gaminume-N may produce increments of platelets in a short period of time, which last longer, thus enabling to be considered a suitable drug for prevention .of severe surgical bleeding complications in patients with ITP.

並列關鍵字

Platelet transfusion Idiopathic thrombocytopenic purpura ； High-dose immunoglobulin infusion