著者

大久保 進 藤井 康英 岡本 緩子 大久保 滉

出版者

関西医科大学医学会

雑誌

関西医科大学雑誌 (ISSN:00228400)

巻号頁・発行日

vol.33, no.1, pp.47-54, 1981-03-20 (Released:2013-02-19)

参考文献数

22

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I. A 26 years old woman, complainig of general malaise and hypermenorrhea was admitted to our hospital in Feb.,1978. She had been suspected of idiopathic thrombocytopenic purpura (ITP) by her home doctor.Laboratory examin ations (Tab.1, Fig.1) revealed thrombocytopenia (26,000/cmm) and abnormal immuno-serological findings, including LE phenomenon (+), LE test (+), DNA test (×640), ANA (×160), BFP (+), RAT ( + ), Coombs test D (+) and hypergammaglobu linemia (1.84-1.36g/di). Her bone marrow picture was typical of ITP, i. e. an increased count in megakaryocytes lacking platelet production.Clinically, the patient showed slig ht fever and sometimes complained of bilateral knee joint Pain.She was diagnosed as SLE, chiefly manifesting thrombocytopenia, and was treated with corticoid (prednisolone), resulting in an improved platelet count (253,000/cmm) in three weeks.II. This case drew our attention to the relationship between ITP and SLE, which led us to investigate the autoantibodies in ten cases of ITP (Tab.2, Figs.2,3) treated at our department during the last five years.1) The positive rates o f the immuno-serological tests in our ITP cases were as follows: Anti-platelet antibody 1/7, LE phenom.0/6, LE test 0/9, DNA test 3/6, ANA 2/9, Microsome test 4/9, Thyroid test 4/9, RAT 4/8, BFP 4/8 and Coombs test 2/4 (Figs.4,5). Comparing these data with those of the SLE cases reported in the literature (Fig.4), some differences suspected to exist between the immunological failure in ITP and that in SLE.2) In all the four ITP cases responding well to corticoid therapy, the BFP was positive: in the non-responding cases, it was negative.In each case, little correlation could be seen between the number of positive tests and response to therapy.The han dling. of ITP cases necessitates a follow up in which attention is paid to the possible concomitance or succession of other auto-immune diseases.An accumulation of case studies in this direction may reveal the pathogenic correlations between ITP and SLE or other auto-immune diseases.