HIV-related severe thrombocytopenia in intravenous drug users: Prevalence, response to therapy in a medium-term follow-up, and pathogenetic evaluation

Giuseppe Landonio, Massimo Galli, Annamaria Nosari, Adriano Lazzarin, Dino Cipriani, Paolo Crocchiolo, Luca Voltolin, Fabio Giannelli, Laura Irato, Francesco De Cataldo, Mauro Moroni

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Abstract

Severe thrombocytopenia (TP) accounted for 5.3% of cases in a consecutive series of 380 HIV-infected intravenous drug users (IVDUs) at presentation. Forty-one of 53 subjects with severe TP showed haemorrhages and were treated as follows: ten were splenectomized, 17 were given high-dose intravenous immunoglobulins (HDIg), and 10 received anti-Rh(D) immunoglobulins (anti-Rh Ig). Splenectomy induced a complete clinical response in all cases: four out of 10 patients maintained platelet counts >100 × 109/I. HDIg gave a good clinical response in all patients, but eight out of 17 suffered haemorrhages during the follow-up and recall treatments were necessary. Six out of 10 patients treated with anti-Rh Ig maintained platelet counts >30 × 109/I, but in two cases the treatment was interrupted because of severe haemolysis. No patient progressed to overt AIDS during the follow-up. Splenectomized patients in particular did not show adjunctive risks of worsening of the HIV-related clinical picture. A platelet kinetic study performed in 20 patients with severe HIV-related TP suggests a possible role for platelet sequestration in TP of HIV-infected IVDUs, in which a liver involvement is very frequent.

Original languageEnglish
Pages (from-to)29-34
Number of pages6
JournalAIDS (London, England)
Volume4
Issue number1
Publication statusPublished - 1990

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Keywords

  • Anti-Rh(D) immunoglobulins
  • High-dose immunoglobulins
  • Intravenous drug users
  • Platelet kinetic study
  • Severe HIV-related thrombocytopenia
  • Splenectomy

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Landonio, G., Galli, M., Nosari, A., Lazzarin, A., Cipriani, D., Crocchiolo, P., Voltolin, L., Giannelli, F., Irato, L., De Cataldo, F., & Moroni, M. (1990). HIV-related severe thrombocytopenia in intravenous drug users: Prevalence, response to therapy in a medium-term follow-up, and pathogenetic evaluation. AIDS (London, England), 4(1), 29-34.