Abstract
The following two problems were brought forth to our attention in patients with autoimmune hepatitis (AIH), idiopathic thrombocytopenic purpura (ITP), and systemic sclerosis (SSc). The first problem is the bleeding tendency due to thrombocytopenia, as well as adverse reactions caused by oral corticosteroid therapy during perioperative management. The second problem is early recurrence or metastasis and the development of malignant tumors at other sites during the postoperative follow-up course because of the high frequency of malignant tumors associated with SSc.
We recently experienced a patient who was diagnosed as having AIH and ITP during preoperative work up for carcinoma of the lower gingival and buccal mucosa. Then the patient was diagnosed for SSc during the postoperative follow-up course. The platelet count of this patient improved with platelet transfusion immediately prior to surgery combined with postoperative corticosteroid therapy. As to the result, the operation was performed safely with no postoperative bleeding or infection. At present, 18 months after surgery, there is no evidence of recurrence, metastasis or development of new malignant tumors at other sites.
