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A 71-year-old woman with active hepatitis type C was admitted due to worsening thrombocytopenia. She was diagnosed with acquired amegakaryocytic thrombcytopenic purpura (AATP). She was administered a course of platelet transfusions, but developed platelet transfusion refractoriness (PTR) due to the production of anti-HLA antibodies. The corrected platelet count increment (CCI) was very low, 0.71×103/μl. We therefore changed treatment to combination therapy with intravenous high-dose gamma globulin and splenectomy. Subsequent to the therapy, the CCI increased to 53.9×103/μl, and the response to random-donor platelets improved. As far as we are aware, this valuable case is the first reported use of combination therapy for PTR caused by alloimmunization.

nihon yuketsu gakkai zasshi/nippon yuketsu gakkai zasshi

CHANGE IN THE KINETICS OF PLATELET TRANSFUSION IN A PATIENT RECEIVING COMBINATION THERAPY WITH HIGH-DOSE INTRAVENOUS GAMMA GLOBULIN AND SPLENECTOMY: IMPROVEMENT IN REFRACTORINESS TO PLATELET TRANSFUSION