Two cases of tooth extraction in a patient with idiopathic thrombocytopenic purpura treated with high-dose intact human immunoglobulin (Venoglobulin-I)

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In a patient with idiopathic thrombocytopenic purpura (ITP), the hemostatic control is considerably troublesome. When a tooth extraction is required in such a case, platelet rich plasma and/or fresh whole blood transfusion has been usually practiced. Though oral surgical treatmant has become convenient with this therapy, serious problems such as a new production of antibodies against platelet happens. Since these antibodies invalidate the effect of transfusiontherapy in lethal bleeding, its use must be deliberate. So we are looking forward to a more suitable method in minor treatments of oral surgery or dentistry.<BR>It was revealed by Imbach et al. in 1981 that high-dose intravenous gammaglobulin therapy was able to increase the number of platelets in ITP. Thereafter the usefulness of this therapy has been ascertained at various clinics and it is considered a new treatment for ITP. By this time no important side effects through this therapy are reported. We consider this therapy is also very useful on our clinics.<BR>We have recently experienced two cases of tooth extraction with this therapy in a patient with ITP and obtained good results. From these experiences we have come to the conclusion that systematic oral or dental care is most imprtant in a patient with ITP or hemorrhagic diathesis.
社団法人日本口腔外科学会の論文