Cardiac Surgery in a Patient with Idiopathic Thrombocytopenic Purpura : Preoperative High-Dose Immunoglobulin Therapy
10.4326/jjcvs.37.108
- VernacularTitle:特発性血小板減少性紫斑病合併症例に対する開心術の1例
- Author:
Hirohisa Ikegami
;
Tomoaki Suzuki
;
Osamu Nishimura
;
Takeshi Kinoshita
;
Atsushi Kambara
;
Keiji Matsubayashi
;
Tohru Asai
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2008;37(2):108-111
- CountryJapan
- Language:Japanese
-
Abstract:
A 62-year-old woman with idiopathic thrombocytopenic purpura (ITP) was admitted to undergo cardiac surgery for aortic stenosis, angina pectoris, and paroxysmal atrial fibrillation. A bleeding tendency was expected due to the dramatic decrease in platelets during cardiopulmonary bypass. We performed high-dose transvenous gammaglobulin infusion (400mg/kg/day) for 5 consecutive days immediately before surgery. The gammaglobulin therapy caused steady increase of thrombocytes from 4 days after surgery, even though the platelet count showed no significant change preoperatively. The postoperative course was satisfactory with neither a bleeding tendency nor wound infection. High-dose transvenous gammaglobulin therapy is thus useful for perioperative patients with accompanying ITP, who are often under medication with steroids. This therapy is also effective for prevention of infection.
