Abstract
A 45-year-old male was admitted because of nasal bleeding and allergic purpura.
Positive hematological laboratory studies showed slight normochromic anemia, platelets 4000, reticulocytes 19‰, positive direct and negative indirect erythrocyte Coombs' test.
After admission, allergic purpura disappeared, but anemia was aggravated, platelets 2900, bleeding time over 30 minutes, reticulocytes 69∼90‰, and other studies revealed a strongly positive erythrocyte Coombs' test and warm type incomplete antibody, showing positive reaction to anti-1gG.
Platelet cold agglutination reaction and platelet Coombs' consumption test were positive and serum immunoelectrophoresis showed decreased IgG, IgA and IgM, deficiency of hemopexin and β1CA.
Bleeding tendencies were subsided, platelet count increased to about 100,000 and reticulocyte count decreased after treatment of 40 mg prednisolone a day.
After splenectomy, platelet count was about 200,000 and antiplatelet antibody became negative, even in the maintenance of 5 mg prednisolone a day.
Erythrocyte Coombs' test turned to be negative after therapy of 6-mercaptopurine.
