This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Response to Splenectomy

Peter A. Schneider, MD; Donald I. Abrams, MD; Anthony A. Rayner, MD; David C. Hohn, MD

Arch Surg. 1987;122(10):1175-1178.

Abstract
• Immunodeficiency-associated thrombocytopenic purpura (IDTP) is a feature of the acquired immunodeficiency syndrome—related complex. Current therapeutic modalities for IDTP include splenectomy and the administration of corticosteroids or other agents. Empiric treatment of IDTP has been analogous to that for immunologic thrombocytopenic purpura (ITP). The present report reviews 15 patients who underwent splenectomy for IDTP, demonstrates the successful use of surgical therapy, and defines our indications for splenectomy in the treatment of this disorder. Thirteen of 15 patients had initially failed to respond to steroid therapy. Fourteen patients (93%) initially responded to splenectomy, with platelet counts increasing to 150 x 10⁹/L (150 000/mm³) or greater. A continuing complete response was achieved in nine patients (60%) following splenectomy. After postsurgical adjunctive therapy, durable remission was achieved in 73% (11/15) of the patients. Complications occurred in three patients, and there were no deaths. The mean follow-up was 12.4 months. Splenectomy may be performed in the treatment of IDTP with acceptable morbidity and likelihood of response.

(Arch Surg 1987;122:1175-1178)

Author Affiliations
From the Departments of Surgery (Drs Schneider, Rayner, and Hohn) and Medicine (Dr Abrams), University of California—San Francisco.

Footnotes
Accepted for publication Oct 27, 1986.

Reprint requests to Room HSE 585, University of California, San Francisco, CA 94143 (Dr Hohn).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Splenectomy for HIV-Related Immune Thrombocytopenia: Comparison With Results of Splenectomy for Non-HIV Immune Thrombocytopenic Purpura
Lord et al.
Arch Surg 1998;133:205-210.
ABSTRACT | FULL TEXT  

Effect of Splenectomy on Slowing Human Immunodeficiency Virus Disease Progression
Tsoukas et al.
Arch Surg 1998;133:25-31.
ABSTRACT | FULL TEXT  

A Growing Spectrum of Surgical Disease in Patients With Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome: Experience With 120 Major Cases
Diettrich et al.
Arch Surg 1991;126:860-866.
ABSTRACT  

Immune Thrombocytopenia in Hemophiliacs Infected With Human Immunodeficiency Virus and Their Response to Splenectomy
Kim et al.
Arch Intern Med 1989;149:1685-1688.
ABSTRACT