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KMID : 0616620020080040427
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Journal of Soonchunhyang Medical College
2002 Volume.8 No. 4 p.427 ~ p.438
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Splenectomy in Adult Idiopathic Thrombocytopenic Purpura
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Abstract
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Splenectomy is accepted as an effective treatment for steroid resistant form of idiopathic thrombocytopenic purpura (especially adult chronic form) because it removes the site of anti-body production and platelet destruction.
Six adult patients underwent splenectomy for idiopathic thrombocytopenic purpura at Soon Chun Hyang University Hospital between 1979 and 1985. Age ranged between 18 and 49 years(mean :36.6 years) and all were females. Presenting manifestations were purpura, epistaxis, gum bleeding, ovarian bleeding, hematuria and persistent bleeding after tooth extration. Duration of disease from onset to splenectomy ranged between 6 wks and 4.5 yrs. The platelet count on adimission was between 13, 000 and 48, 000/㎣. (mean : 25, 000).
Five patients (83. 3%) had complete remission and had no relapse during follow-up periods of 3 months to 6 1/4 years. The one who failed to achieve remission after splenectomy became resistant to steroid or immunosuppressive agents. Those who achieved complete remission had shorter duration of disease till splenectomy, immediate rise in platelet count to normal level after surgery and tended to reach maximal platelet count sooner after surgery.
There was no complication associated with splenectomy.
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