Improvement of Bleeding Tendency and normalized Platelet Count Increment following Splenectomy in a Patient with Refractory Anemia

• KAWAI Yasukazu

  First Department of Internal Medicine, Fukui Medical School

• FUKUSHIMA Toshihiro

  First Department of Internal Medicine, Fukui Medical School

• OOKURA Kiyotaka

  First Department of Internal Medicine, Fukui Medical School

• YOSHIO Nobuyuki

  First Department of Internal Medicine, Fukui Medical School

• YAMAUCHI Takahiro

  First Department of Internal Medicine, Fukui Medical School

• NAKAYAMA Takashi

  First Department of Internal Medicine, Fukui Medical School

• TOHYAMA Kaoru

  First Department of Internal Medicine, Fukui Medical School Department of Laboratory Medicine, Kyoto University

• WANO Yuji

  Division of Transfusion Medicine, Fukui Medical School

• TSUTANI Hiroshi

  First Department of Internal Medicine, Fukui Medical School

• UEDA Takanori

  First Department of Internal Medicine, Fukui Medical School

• NAKAMURA Toru

  First Department of Internal Medicine, Fukui Medical School

Bibliographic Information

Other Title

• 脾摘により血小板輸血への反応性と出血傾向が改善した不応性貧血

Abstract

A 72-year-old woman with refractory anemia had severe bleeding tendency. Since 1994, platelet transfusions (10 units three times per week) were unable to maintaining her platelet count over 10×10³/μl. Her hemoglobin was decreased to 3.9 g/dl as a result of bleeding from early gastric cancer. At one-hour after posttransfusion corrected platelet count increment (1-hour CCI) was slightly low, as 14×10³/μl/m², A 24-hour posttransfusion CCI (24-hour CCI) and the (24-hour CCI)/(1-hour CCI) ratio were markedly low, as 0.5/μl/m² and 0.36, respectively. Anti-HLA antibody was not detected. The ineffectiveness of platelet transfusion was suspected to be highly associated with splenomegaly. Her spleen had been gradually increased in size since the first clinical examination. She underwent both subtotal gastrectomy and splenectomy, while receiving 40 units of platelet transfusion. After splenectomy, the 1-hour CCI and the (1-hour CCI)/(24-hour CCI) ratio markedly improved (76×10³/μl/m² and 0.79, respectively). Cutaneous bleeding halted and there have been no further episodes, despite less frequent platelet transfusions. This is the first report in which bleeding tendency and CCI were improved by splenectomy in a case of myelodysplastic syndrome.

Journal

• Rinsho Ketsueki

  Rinsho Ketsueki 38 (6), 532-538, 1997

  The Japanese Society of Hematology

Keywords

• refractory anemia
• thrombocytopenia
• platelet transfusion
• splenectomy

Details

• CRID: 1390001205030849792
• NII Article ID: 130004500398
• NII Article ID: 10013304949
• NII Article ID: 10013847387
• NII Book ID: AN00252940
• DOI: 10.11406/rinketsu.38.532
• COI: 1:STN:280:DyaK2szptFGmug%3D%3D
• ISSN: 18820824
• ISSN: 04851439
• PubMed: 9248330
• Web Site: https://search.jamas.or.jp/link/ui/1997250014
• Text Lang: ja
• Data Source:
  • JaLC
  • PubMed
  • CiNii Articles
  • Crossref
• Abstract License Flag: Disallowed