Thrombotic Thrombocytopenic Purpura Achieving Complete Remission by Slow Infusion of Vincristine
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- YOKOYAMA Kenji
- Department of Internal Medicine, Ashikaga Red Cross Hospital
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- KOJIMA Masaru
- Department of Pathology, Ashikaga Red Cross Hospital
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- KOMATSUMOTO Satoru
- Department of Internal Medicine, Ashikaga Red Cross Hospital
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- NARA Masaharu
- Department of Internal Medicine, Ashikaga Red Cross Hospital
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- NAKANO Masaru
- The First Department of Internal Medicine, Tokyo Medical College
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- IKEDA Yasuo
- Department of Internal Medicine, Keio University School of Medicine
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- TOYAMA Keisuke
- The First Department of Internal Medicine, Tokyo Medical College
Bibliographic Information
- Other Title
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- ビンクリスチン緩速静注法により寛解を得た血栓性血小板減少性紫斑病の1例
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Abstract
A case of thrombotic thrombocytopenic purpura (TTP) which was successfully treated by slow infusion of vincristine (VCR) is reported. A 40-year-old female was admitted to our hospital because of sudden onset of genital bleeding. Her blood cell count showed severe anemia and thrombocytopenia. Biochemistry disclosed high titers of serum LDH. Based upon these findings, the patient was initially diagnosed as having Evans syndrome and was treated with steroid-pulse therapy and high-dose immunoglobulin. However, no response was obtained. A diagnosis of TTP was established when mental disturbance and renal dysfunction developed later. Aspirin and plasmapheresis relieved the mental disturbance and decreased serum LDH level, but anemia and thrombocytopenia were not corrected. Slow infusion therapy of 1 to 2 mg VCR was performed for 4 to 8 hours once a week, which dramatically improved the hematological abnormalities and controlled the disease. In conclusion, slow infusion of VCR may indicated, if initial standard therapies such as PE would fail.
Journal
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- Rinsho Ketsueki
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Rinsho Ketsueki 33 (8), 1084-1089, 1992
The Japanese Society of Hematology