PMID: 7023309Sep 1, 1981Paper

Intravenous prostacyclin in thrombotic thrombocytopenic purpura

Annals of Internal Medicine
G A FitzgeraldL J Roberts

Abstract

A therapeutic trial of prostacyclin (PGI), was done in a patient with thrombotic thrombocytopenic purpura resistant to treatment with antiplatelet drugs and plasmapheresis. Despite marked thrombocytopenia and continued treatment with aspirin, sulfinpyrazone, and dipyridamole, the urinary excretion of 2,3-dinor-thromboxane B2, a major thromboxane urinary metabolite, was within the normal range (90.3 to 368 pg/mg creatinine) at 96 pg/mg creatinine. Because of its potent antiaggregatory properties and the possibility of a defect in endogenous PGI2 production in thrombotic thrombocytopenic purpura, synthetic PGI2 (4 to 10 ng/kg-1 . min-1) was infused intravenously, first for 72 hours and then continuously for 18 days. Prostacyclin markedly reduced the excretion of 2,3-dinor-thromboxane B2, and the platelet count rose steadily to reach 100 000/mm3 by the eighth day of the second infusion. The patient remains in clinical remission, on no therapy, 7 months later. A controlled evaluation of PGI2 in thrombotic thrombocytopenic purpura is warranted. Apparent therapeutic failure in previous cases may have resulted from inadequate prolongation of PGI2 infusion.

Citations

Jan 1, 1983·General Pharmacology·E A Higgs, S Moncada
Nov 16, 1985·Lancet·A R MortonK Mundy
Dec 2, 2000·Biomedicine & Pharmacotherapy = Biomédecine & Pharmacothérapie·A SagripantiA Carpi
Jan 1, 1996·Biomedicine & Pharmacotherapy = Biomédecine & Pharmacothérapie·A SagripantiA Nicolini
Oct 18, 2000·Journal of Clinical Gastroenterology·S VaradarajuluR H Israel
Jan 15, 1996·Thrombosis Research·C PirichH Sinzinger
May 1, 1984·European Journal of Obstetrics, Gynecology, and Reproductive Biology·H GraeffR Schröck
Jan 1, 1984·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·D C Cattran
Jun 1, 1983·Thrombosis Research·F J ZijlstraJ E Vincent
Jan 1, 1993·Nihon rinsho. Japanese journal of clinical medicine·T Koyama, E Kakishita
Mar 1, 1983·Stroke; a Journal of Cerebral Circulation·S Moncada
Dec 1, 1982·Postgraduate Medicine·O I Linet

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