An operative application of Cyclosporine in inhibitory T cell elevation of pediatric chronic refractory immune thrombocytopenia
10.3760/cma.j.cn101070-20200207-00123
- VernacularTitle:应用环孢素治疗抑制性T淋巴细胞明显异常增生的慢性难治性免疫性血小板减少症1例
- Author:
Hao GU
;
Jie MA
;
Jingyao MA
;
Lingling FU
;
Rui ZHANG
;
Tianyou WANG
;
Runhui WU
- From:
Chinese Journal of Applied Clinical Pediatrics
2021;36(9):699-702
- CountryChina
- Language:Chinese
-
Abstract:
The clinical and laboratory data of a patient with chronic refractory immune thrombocytopenia (ITP) who had a significant increase in the proportion of inhibitory T cells in the hematological oncology center of Beijing Children′s Hospital Affiliated to Capital Medical University in February 2018 and regularly followed up in the outpatient department received a retrospective analysis.This 8-year-old patient′s clinical features were 6 years of skin and mucous membrane bleeding spots and petechiae recurring, with occasionally nasal epistaxis.Physical examination: cardiopulmonary abdomen and nervous system examinations are normal, and no superficial lymphadenopathy is touched.Blood routine indicated that the platelets were 2.00×10 9/L, and white blood cell count and hemoglobin level were normal.Bone marrow suggested that hyperplasia was significantly active, with more than 300 megakaryocytes.The patient was diagnosed with ITP, and he was treated with first-line treatment with gamma globulin and oral Corticosteroids.The first-line treatment with high-dose Dexamethasone therapy was repeated, and the second-line treatment was low-dose Rituximab combined with high-dose Dexamethasone.Evaluations had been conducted with every relapsed course, and Cyclosporine was administered orally on the basis of the highly suppressive T cells.After half a month, the child achieved partial remission and continued for 3 months, and then reached a complete remission of 6 months (till this paper). It is suggested that, with ITP as an immunological disease with high heterogeneity, the immune abnormality index is expected to become a breakthrough in the development of precise treatment.
