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The site of platelet destruction in thrombocytopenic purpura as a predictive index of the efficacy of splenectomy.

Abstract
The significance of the site of platelet sequestration in determining the indication for splenectomy in idiopathic thrombocytopenic purpura (ITP) is a controversial subject. However, most of the negative conclusions are based on 51chromium labelling of homologous platelets. We report here the results of an analysis of 222 cases in which the kinetic study of 111indium-oxinate-labelled autologous platelets was performed under homogeneous technical conditions. 103 of these patients subsequently underwent splenectomy. This study demonstrates that the site of platelet sequestration in active ITP constitutes a variable independent of the patient's age, history of the disease and its severity (platelet count, lifespan). The sequestration site is a good predictive element of the short-term efficacy of splenectomy (71/76 cases with splenic sequestration obtained a platelet count exceeding 100 x 10(9)/l versus 7/13 cases with mixed sequestration and 1/14 cases with hepatic sequestration), and the long-term results (6 months to 5 years after splenectomy) do confirm the clinical value of this study.
AuthorsY Najean, V Dufour, J D Rain, M E Toubert
JournalBritish journal of haematology (Br J Haematol) Vol. 79 Issue 2 Pg. 271-6 (Oct 1991) ISSN: 0007-1048 [Print] England
PMID1958485 (Publication Type: Journal Article)
Chemical References
  • Indium Radioisotopes
Topics
  • Adolescent
  • Adult
  • Age Factors
  • Blood Platelets (pathology)
  • Cell Survival (physiology)
  • Female
  • Humans
  • Indium Radioisotopes
  • Kinetics
  • Liver (pathology)
  • Male
  • Middle Aged
  • Platelet Count
  • Purpura, Thrombocytopenic, Idiopathic (blood, physiopathology, surgery)
  • Spleen (pathology)
  • Splenectomy
  • Time Factors

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