[Infection-induced transient increase in the platelet count, and a transient remission of thrombocytopenia with high-dose intravenous gammaglobulin therapy during intercurrent pneumonia in chronic idiopathic thrombocytopenic purpura].

A patient with chronic idiopathic thrombocytopenic purpura (ITP), who had a transient increase in platelet count during infectious episodes, and had a transient remission of thrombocytopenia with administration of high-dose intravenous gammaglobulin during intercurrent pneumonia was described. A 64-year-old Japanese woman with a 12-year history of chronic ITP was refractory to steroids and azathioprine, and the platelet count was constantly less than 10 x 10(9)/l. During both acute upper respiratory infections and chronic cystitis due to E. coli, the platelet count transiently increased to more than 40 x 10(9)/l. High-dose intravenous gammaglobulin therapy successfully induced a remarkable increase in the platelet count, which persisted for 3 months, when gammaglobulin was administered during the intercurrent pneumonia. The bleeding tendency disappeared and transient remission of ITP was obtained. In contrast, the clinical efficacy of high-dose intravenous gammaglobulin proved to be only transient and slight, when administered before the onset of pneumonia or after recovery from pneumonia. These phenomena may suggest that high-dose gammaglobulin may enhance some positive mechanisms related to platelet increment in infectious diseases accompanied with chronic ITP.