Plasma Exchange in the Treatment of Fulminant Idiopathic (Autoimmune) Thrombocytopenic Purpura

High dose immunoglobulin infusions showed a marked effect on platelet counts in eight out of nine chronic ITP patients and in one SLE patient. In the comparison of different IgG-preparations, the pepsin treated IgG F (ab')2 showed no platelet elevation while the sulfonated did. The elevated platelet count could not be maintained after discontinuation of IgG infusions, but in six out of ten patients the platelet level remained above the pretreatment values. This new treatment seems to be safe and effective in adulthood ITP.

show abstract

“…In some patients, however, these agents induce an unsatisfactory increase in platelet count. Other approaches have therefore been studied [3,4].…”

Section: Introductionmentioning

confidence: 99%

Clinical effect of intravenous immunoglobulin on chronic idiopathic thrombocytopenic purpura

Abe

Matsuda

Kawasugi

et al. 1983

Blut

View full text Add to dashboard Cite

show abstract

“…Plasma exchange has been shown to be helpful in fulminant ATP [12][13][14] but this was not the case in 1 patient with chronic ATP [15]. In 2 of our chronic patients (cases 1 and 4) we were able to maintain the platelet count above the patients own baseline with abolition of bleeding manifestations.…”

Section: Discussionmentioning

confidence: 80%

“…in ATP [12][13][14] might have a useful place in the management of refractory cases. We tried plasma exchange on 5 patients in whom conventional therapy was inade quate.…”

Section: Introductionmentioning

confidence: 99%

Plasma Exchange in Autoimmune Thrombocytopenic Purpura

Cotter¹,

Newland²,

Turnbull³

1983

Vox Sanguinis

View full text Add to dashboard Cite

We present data on 5 cases with autoimmune thrombocytopenic purpura treated with plasma exchange in whom conventional drug therapy had been ineffective. In 3, preparation for splenectomy allowed the operation to be performed without bleeding problems. 1 patient who was unfit for splenectomy underwent successful coronary artery vein grafting following preparation with plasma exchange. 2 patients were maintained for variable periods with intermittent exchanges, 1 prior to splenectomy and 1 post-splenectomy. In summary we had no prolonged response to plasma exchange but found it a useful technique as preparation for or adjunctive to more conventional therapy. It was also helpful in patients unresponsive to other forms of therapy who required a brief increase in platelet count to cover surgery or spontaneous haemorrhage.

show abstract

“…68 Its use in the pregnant woman has not been widely studied, and although maternal antibody levels can be reduced and platelet levels rapidly raised, this effect is not predictable. 10 Little is known about the fetal platelet count after plasmapheresis.…”

Section: Plasmapheresismentioning

confidence: 99%

Immune thrombocytopenia in pregnancy

Browning¹,

James²

1990

Fet. Matern. Med. Rev.

View full text Add to dashboard Cite

Autoimmune thrombocytopenia (ITP)1) The risks to mother and fetus have previously been overstated.2) There is no maternal test which will accurately determine fetal thrombocytopenia.3) The only reliable test for fetal thrombocytopenia is cordocentesis – this carries a higher morbidity than that of fetal intracerebral haemorrhage from ITP.4) Contrary to received wisdom, there is no evidence that, even for the most severely thrombocytopenic infant, abdominal delivery protects against intracranial haemorrhage.5) Management therefore involves keeping the maternal platelet count above 50 × 1091 and choosing the route of delivery on normal obstetric grounds.Alloimmune thrombocytopenia1) Alloimmune thrombocytopenia is commoner than hitherto believed (0.15% all neonates).2) The fetal risks are considerable: intracranial haemorrhage occurs in 4% of cases antenatally and in 10% in labour. The risks are virtually confined to those with a platelet count of less than 30 × 109l−1.3) Cordocentesis is justified for the ‘at risk’ fetus; fetal immunoglobulin or platelet therapy can be given.4) When the fetal platelet count is below 50 × 109l−1, abdominal delivery should be planned.5) A maternal screening test for neonatal alloimmune thrombocytopenia exists (lack of P1A1 antigen).

show abstract

Plasma Exchange in the Treatment of Fulminant Idiopathic (Autoimmune) Thrombocytopenic Purpura

Cited by 55 publications

References 9 publications

Clinical effect of intravenous immunoglobulin on chronic idiopathic thrombocytopenic purpura

Clinical effect of intravenous immunoglobulin on chronic idiopathic thrombocytopenic purpura

Plasma Exchange in Autoimmune Thrombocytopenic Purpura

Immune thrombocytopenia in pregnancy

Contact Info

Product

Resources

About