Immunoglobulin Treatment Before Vascular Surgery in Patients with Chronic Idiopathic Thrombocytopenia

Abstract

The authors describe 2 patients with chronic idiopathic thrombocytopenic purpura (ITP) associated with atherosclerotic peripheral vascular disease dem onstrated by Doppler examination and digital intravenous arteriography.

Two weeks before surgical treatment, a daily venous infusion (for five days) of 400 mg/kg of immunoglobulin was performed. The platelet count at the be ginning of treatment was 23,000/mm³ in the first patient and 25,000/mm³ in the second. Ten days later, the patients had a good response with a platelets increase of 151,000/mm³ and 162,000/mm ³ respectively. Subsequently two aortobife moral operations were required without surgical or ITP-related complications.

At the follow-up the platelet count was 110,000/mm³ in the first patient (ten months) and 132,000/mm ³ in the second (fourteen months).

Their results suggest that an adequate preoperative preparation in patients with chronic ITP may lead to a good response without postoperative bleeding or other complications.

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