Abstract
We experienced a case of early gastric cancer associated with ITP, and gastrectomy and splenectomy were subsequently performed. As a preoperative treatment, the patient was given 303mg/kg of complete molecular-type Ig for five days, inducing an increase in the number of thrombocytes from 12, 000/mm3 to 79, 000/mm3. Although the volume of bleeding during surgery was 706g and the level of thrombocytes was maintained immediately after surgery, the level decreased rapidly and bleeding began due to drainage on the seventh day after surgery. However, the wound was subsequently healed again with the same dose of Ig preparation. The postoperative course was uneventful for a while but no increase in thrombocytes could be achieved by administration of prednisolone, resulting in the appearance of hemothorax, hematuria and subsequently death due to hemoptysis on the 65th day after surgery.
Therapy with a large quantity of complete molecular-type Ig for ITP may be very useful for surgical procedures necessitating a transient increase in thrombocytes, whereas further consideration regarding its medication and dosage may be needed before applying it as a form of radical treatment.
