ガンマグロブリン大量療法とプレドニゾロン併用療法が奏功した妊娠合併急性型特発性血小板減少性紫斑病の１例

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We report a case of acute idiopathic thrombocytopenic purpura (ITP) during pregnancy, which was successfully treated by a combination of high-dose γ-globulin and prednisolone (PSL).A 30-year-old female was admitted to our hospital in the 11th week of pregnancy due to bleeding.Laboratory data revealed severe thrombocytopenia (2,000/μl)with normal red blood cell and white blood cell counts,and she was diagnosed as having ITP.Both PSL alone (45mg/day for 4 weeks)and high-doseγ-globulin therapy alone (400mg/kg/day for 5 days)were transiently effective but resulted in a rapid decrease in the platelet count to under 10,000/μl. However,a combination of PSL (45mg/day,for 2 weeks)and high-doseγ-globulin (400mg/kg/day for 5 days) markedly increased her platelet count,which was maintained at over 90,000/μl.She delivered a healthy 2,050g male vaginally without complications in the 39th week of pregnancy. Although PSL was discontinued after delivery, no thrombocytopenia was observed. A combination of PSL and high-dose γ-globulin may be effective for cases of refractory ITP during pregnancy.
信州医学会の論文
1999-08-10