Thrombocytopheresisにより血小板機能の改善をみた原発性血小板血症の一例

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タイトル別名
  • Therapeutic Thrombocytopheresis in a Case of Primary Thrombocythemia
  • Thrombocytopheresisにより血小板機能の改善をみた原発性血小板血症の1例
  • Thrombocytopheresis ニ ヨリ ケッショウバン キノウ ノ

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A 64-year-old male was admitted with a chief complaint of giant hematoma on left lateral site of the chest on May 12, 1980. On admission, leukocytosis, slight hypochromic anemia, marked thrombocytosis and hepatosplenomegaly were noted. Serum LDH, uric acid and potassium levels were high.<br>Chromosome analysis was normal and NAP score was slightly elevated. He had normal marrow cellularity with erythroid hypoplasia and normal megakaryocyte count. He was diagnosed as primary thrombocythemia. He showed remarkable hemorrhagic diathesis with hematoma in increasing size and new hematoma formation. Hemonetics blood processor model 30 was applied to the patient for the safe and rapid mechanical removal of platelets. Platelets of 4-5×1012 were removed by this procedure per a time. Aggregability and release ability were studied on the platelets obtained from patient before and after thrombocytopheresis. Before thrombocytopheresis, ADP-, collagen-, epinephrine- and ristocetin-induced platelet aggregation were markedly impaired, and these functions did not recover by PRP-dilution with patient plasma to normal platelet count. Function tests of platelets obtained from patient after thrombocytopheresis recovered to fairly normal values.<br>These results indicated the possibilities that something in vivo other than platelets might affect the platelet functions. Thrombocyte count was fallen to about 200×104/cmm and serum LDH, uric acid and potassium were decreased to normal level by serial thrombocytopheresis. Then carboquone was administered and thrombocyte count became to normal level.<br>Thrombocytopheresis is a useful method for treatment of hemorrhagic diathesis and for prevention of uricemic nephropathy, which might develope after chemotherapy, in primary thrombocythemia.

収録刊行物

  • 臨床血液

    臨床血液 23 (2), 215-223, 1982

    一般社団法人 日本血液学会

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