摘脾の適応と予後

抄録

During the past thirteen years (from July 1971 to June 1984) 89 patients with chronic idiopathic thrombocytopenic purpura, including 3 cases of Evans' syndrome, were treated in our clinic. In all cases, diagnosis was confirmed by laboratory tests including platelet kinetics with ⁵¹Cr. Treatment was started with prednisolone 1 mg/kg body weight/day and 12 cases attained remission. In 25 cases out of 38 platelet counts were maintained above 100×10³/μl and one case above 70×10³/μl without therapy from 17 to 146 months after splenectomy. Favorable factors to splenectomy were as follows: younger age especially under 30, spleen dominant pattern in surface counting, prolonged platelet life span after splenectomy and small number of foam cells in spleen. Duration of the illness, initial response to steroid and platelet life span before splenectomy were equivocal.
Importance of longtime followup of the splenectomized patients was emphasized.