TY - JOUR
T1 - HIV-related severe thrombocytopenia in intravenous drug users
T2 - Prevalence, response to therapy in a medium-term follow-up, and pathogenetic evaluation
AU - Landonio, Giuseppe
AU - Galli, Massimo
AU - Nosari, Annamaria
AU - Lazzarin, Adriano
AU - Cipriani, Dino
AU - Crocchiolo, Paolo
AU - Voltolin, Luca
AU - Giannelli, Fabio
AU - Irato, Laura
AU - De Cataldo, Francesco
AU - Moroni, Mauro
PY - 1990
Y1 - 1990
N2 - 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.
AB - 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.
KW - Anti-Rh(D) immunoglobulins
KW - High-dose immunoglobulins
KW - Intravenous drug users
KW - Platelet kinetic study
KW - Severe HIV-related thrombocytopenia
KW - Splenectomy
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M3 - Article
C2 - 2156528
AN - SCOPUS:0025164735
VL - 4
SP - 29
EP - 34
JO - AIDS
JF - AIDS
SN - 0269-9370
IS - 1
ER -