More on anti-D for the treatment of splenectomized patients with immune thrombocytopenic purpura.
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Biomedical subjects
Publications and source records attributed to B Boughton.
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Previous work in our department showed that after blood transfusion, the platelet count often falls to levels which are clinically significant. The probable site of platelet sequestration was identified as the spleen, and post-transfusion thrombocytopenia was prevented by blood filters which remove microaggregate debris from the donor blood. Since the duration of the thrombocytopenia has not been investigated, the purpose of the present study was to establish the rate of onset and duration of post-transfusion thrombocytopenia following packed red blood cell transfusions. In addition, the effect of spleen size, patients' diagnosis and post-transfusion history were examined. These observations provide interesting new data on the mechanisms involved in this phenomenon.
We have measured skin mast cell numbers, circulating basophils and whole blood histamine in 13 patients with polycythaemia vera. Itching was present in nine cases and correlated well with the numbers of skin mast cells but not with circulating basophils or whole blood histamine. Immediate relief of pruritus was achieved with aspirin, and myelosuppressive therapy was useful for long-term control of symptoms. Neither histamine (H1 or H2) antagonists nor iron replacement therapy were effective forms of treatment. The findings suggest that mast cell prostaglandins are an important factor in the pathogenesis of pruritus and that local vascular responses may trigger mast cell degranulation.