Progressive Systemic Sclerosis Complicated with Immune Thrombocytopenia during D-penicillamine Therapy

Hiromiki NATSUDA; Yoshiki MATSUI; Michihiro SAKAUCHI; Shinjiro KATO; Hiroyuki TAKEMURA; Hiroshi SUZUKI; Ichiro KONO; Kazuhide YAMANE; Heihachiro KASHIWAGI

doi:10.2169/internalmedicine.31.244

Hiromiki NATSUDA, Yoshiki MATSUI, Michihiro SAKAUCHI, Shinjiro KATO, Hiroyuki TAKEMURA, Hiroshi SUZUKI, Ichiro KONO, Kazuhide YAMANE, Heihachiro KASHIWAGI

Author information

Hiromiki NATSUDA
Department of Internal Medicine, Institute of Clinical Medicine, University of Tsukuba
Yoshiki MATSUI
Department of Internal Medicine, Institute of Clinical Medicine, University of Tsukuba
Michihiro SAKAUCHI
Department of Internal Medicine, Institute of Clinical Medicine, University of Tsukuba
Shinjiro KATO
Department of Internal Medicine, Institute of Clinical Medicine, University of Tsukuba
Hiroyuki TAKEMURA
Department of Internal Medicine, Institute of Clinical Medicine, University of Tsukuba
Hiroshi SUZUKI
Department of Internal Medicine, Institute of Clinical Medicine, University of Tsukuba
Ichiro KONO
Department of Internal Medicine, Institute of Clinical Medicine, University of Tsukuba
Kazuhide YAMANE
Department of Internal Medicine, Institute of Clinical Medicine, University of Tsukuba
Heihachiro KASHIWAGI
Department of Internal Medicine, Institute of Clinical Medicine, University of Tsukuba

Keywords: platelet-associated IgG, drug-induced thrombocytopenia

JOURNAL FREE ACCESS

1992 Volume 31 Issue 2 Pages 244-245

DOI https://doi.org/10.2169/internalmedicine.31.244

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Abstract

Immune thrombocytopenia is a rare complication of progressive systemic sclerosis (PSS). A 47-year-old female with PSS treated with D-penicillamine developed immune thrombocytopenia, which promptly responded to prednisolone and withdrawal of D-penicillamine. Platelet-associated IgG was elevated and the bone marrow megakaryocyte count was normal. There was an inverse relationship between the level of platelet-associated IgG and the platelet count. A lymphocyte stimulation test sensitized by D-penicillamine was positive. The present case suggests that immunethrombocytopenia may be regarded as one of the D-penicillamine-related immune abnormalities. To our knowledge, its association with PSS has never been reported.
(Internal Medicine 31 : 244-245, 1992)

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