演題詳細

一般口演 / Oral Session

一般口演 88 (Oral Session 88) :ITP・トロンボポエチン (ITP and Thrombopoietin)

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日程
2013年10月13日(日)
時間
09:15 - 10:45
会場
第13会場 / Room No.13 (札幌市教育文化会館 3F 研修室301)
座長・司会
宮崎 浩二 (Koji Miyazaki):1
1:北里大学医学部 血液内科学
 
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Efficacy of romiplostim for a severe case of ITP with an extremely low platelet level

演題番号 : OS-3-81

城下 翠 (Midori Joshita):1、渡部 玲子 (Reiko Watanabe):1、富川 武樹 (Tatsuki Tomikawa):1、佐川 森彦 (Morihiko Sagawa):1、多林 孝之 (Takayuki Tabayashi):1、根本 朋恵 (Tomoe Nemoto):1、木村 勇太 (Yuta Kimura):1、高橋 康之 (Yasuyuki Takahashi):1、得平 道英 (Michihide Tokuhira):1、森 茂久 (Shigehisa Mori):1、大瀧 聡史 (Satoshi Otaki):2、大井 秀則 (Hidenori Oi):2、澤野 誠 (Makoto Sawano):2、杉山 聡 (Satoshi Sugiyama):2、木崎 昌弘 (Masahiro Kizaki):1

1:Dept. Hematology, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan、2:Dept. Emergency and Clitical Care Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan

 

A72-year-old woman intentionally cut the right side of her neck using a razor blade and was transported to our emergency room. On admission, she was in shock with massive bleeding from her wound. Her hemoglobin level had decreased to 4.7g/dl and her platelet count was only 2×103/μL. Her white blood cell count was 68×103/μL and contained no abnormal cells. The depth of the wound extended to the right common carotid artery. The artery was sutured and the patient was transfused a large quantity of blood. However, she showed no response to platelet transfusion. Active oozing from the wound continued and her platelet count remained at 2×103/μL. Subsequently, she was diagnosed with immune thrombocytepenic purpura (ITP). High-dose immunoglobulin and prednisolone were administered and helicobacter pylori-eradication was initiated. Seven days later, oozing continued and her platelet count remained at 2×103/μL. Therefore, we decided to administer romiplostim (3μg/kg). Six days after romiplostim infusion, the patient's platelet count had increased to 23×103/μL, and oozing had improved. A splenectomy was immediately performed, and by the next day her platelet count had increased to 260×103/μL. At 47 days after admission, her wound had completely recovered and her platelet count was within the normal range. Herein, we report a rare and severe case of ITP successfully treated with early administration of romiplostim.

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