Abstract
A 39-year-old male patient with gastric carcinoma associated with idiopathic thrombocytopenic purpura is reported. A total of 125g of complete molecular-type γ-globulin (400mg/kg/day) and 10 units of platelets were administered preoperatively. When prepoerative platelet counts increased from 7.3×104/mm3 to 18.8×104/mm3 with these treatments, total gastrectomy with regional lymph node dissection and splenectomy were safely performed without blood transfusion. Postoperative administration of 20 units of platelets resulted in maintaining of stable platelet count at approximately 80×104/mm3. Postoperative course was uneventful and the patient was discharged on 21st day after surgery.
A large quantity of intact γ-globulin regimen, which can increase platelet count safely and certainly in a short time, may be most appropriate in ITP cases necessitating a transient increase in thrombocytes for surgical procedures in which other drugs are ineffective, and hemorrhagic tendency is severe.
