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MV Ragni, FA Bontempo, DJ Myers, JE Kiss and A Oral
Department of Medicine, University of Pittsburgh School of Medicine, PA.
Clinical bleeding tendency and tests of immune function were studied
prospectively in 11 human immunodeficiency virus (HIV)-infected
hemophiliacs with immune thrombocytopenic purpura (ITP) and a platelet
count less than 50,000/microL. These 11 patients represented 13% of a
well-characterized cohort of 87 HIV + hemophiliacs. ITP developed a mean
3.5 years after seroconversion, mean platelet count at presentation was
36,000/microL (range 15,000 to 49,000/microL), and the mean age at
seroconversion was 37.1 years. Nine patients (82%) suffered bleeding
complications, including four with intracranial hemorrhage, which was fatal
in three. At the onset of ITP, five had AIDS and six were asymptomatic.
Mean T4 lymphocyte count at onset of ITP was 126 +/- 32/microL (range 5 to
267/microL). Sustained treatment responses occurred with intravenous
gammaglobulin (2 of 2), one of whom spontaneously remitted, and with
zidovudine (1 of 2), but not with steroids (0 of 6) or danazol (0 of 3). In
conclusion, 13% of a cohort of HIV + hemophiliacs has developed ITP with
platelets less than 50,000/microL, a significant proportion of whom (82%)
have experienced bleeding complications. It is recommended that treatment
for ITP in HIV + hemophiliacs be instituted once the platelet count falls
below 50,000/microL in order to avoid serious hemorrhagic sequelae.
This article has been cited by other articles:
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| Copyright © 1990 by American Society of Hematology Online ISSN: 1528-0020 | |||||||||
