Experience of Open-Heart Surgery for Idiopathic Thrombocytopenic Purpura (ITP) Refractory to Corticosteroids—Combined High-Dose Intravenous Gammaglobulin and Thrombopoietin Receptor Agonist
- VernacularTitle:副腎皮質ステロイド療法抵抗性の特発性血小板減少性紫斑病（ITP）に対する開心術経験 －ガンマグロブリン大量静注療法およびトロンボポエチン受容体作動薬の併用－
- Author:
Masao YAMADA
1
;
Jun YOKOTE
1
;
Masato YAMAKAWA
1
;
Shinichi ASHIDA
1
;
Hiroki HASEGAWA
1
;
Yukifusa YOKOYAMA
1
Author Information
- Keywords: idiopathic thrombocytopenic purpura; open heart surgery; thoracic aortic aneurysm; intravenous immunoglobulin therapy; thrombopoietin receptor agonists
- From:Japanese Journal of Cardiovascular Surgery 2024;53(4):220-224
- CountryJapan
- Language:Japanese
- Abstract: The patient was a 73-year-old man. We have performed an ascending aortic prosthesis replacement for a thoracic aortic aneurysm complicated by idiopathic thrombocytopenic purpura (ITP). The platelet count was not sufficiently increased neither by preoperative Helicobacter pylori (H. pylori) eradication nor corticosteroid therapy. After treatment with high-dose intravenous gammaglobulin (400 mg/kg/ day×5 days) and the use of thrombopoietin receptor agonists, the platelet count increased to 8.9×104/ μl and the operation was safely performed. With a steady increase in platelet count, the patient continued to do well post-operatively. We report a case in which a stable platelet count was achieved throughout the perioperative period by the effective combination of high-dose intravenous gammaglobulin and a thrombopoietin receptor agonist in a patient with ITP refractory to corticosteroid therapy.
