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Protein A Immunoadsorption Therapy in HIV‐Related Immune Thrombocytopenia: A Preliminary Report
Author(s) -
Bertram Juergen H.,
Snyder Harry W.,
Gill Parkash S.,
Shulman Ira,
Henry David H.,
Jenkins Donella,
Kiprov Dobri D.
Publication year - 1988
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/j.1525-1594.1988.tb02809.x
Subject(s) - immunoadsorption , platelet , complement system , antibody , immune system , medicine , immunology
Nine homosexual patients with immune thrombocytopenia were treated with autologous plasma that had been perfused over silica‐immobilized Staphylococcus aureus protein A (SpA). Pretreatment platelet counts ranged from 10,000 to 98,000 cells/mm 3 (mean: 54,000 cells/mm 3 ). Six patients responded to therapy. Platelets increased by a mean of 95,000 cells/mm 3 (p<0.007) and reached normal levels (>150,000 cells/mm 3 ) in four patients. Increased platelet counts are presently sustained in these four individuals after 5 months of follow‐up. Increases in platelet counts significantly correlated with decreases in platelet‐associated IgG (PAIgG), platelet‐directed IgG (PDIgG), and immune complexes (CIC). PAIgG and PDIgG declined by a mean of 67% (p<0.003) and 58% (p<0.007), respectively. CIC decreased by a mean of 37% (p=0.02). Complement was concomitantly activated in all four examined patients. C3a and C5a increased 23‐fold and 2.6‐fold, respectively, while total hemolytic complement decreased by 50%. Activated complement components and removal of CIC and IgG thus may contribute to the platelet‐enhancing activity of SpA immunoadsorption therapy.