Key result
Immunosuppressive therapy resolves bleeding and normalizes platelet function in a patient with GP IIIa autoantibodies.
Case Report (n=1)
Autoantibodies against platelet glycoprotein IIIa can cause severe platelet dysfunction and bleeding despite normal platelet counts, which can be reversed with immunosuppressive therapy.
May warrant immunosuppression trial in refractory anti-GPIIIa platelet dysfunction; leaves open generalizability and safety in larger cohorts.
A young patient developed chronic idiopathic thrombocytopenic purpura. Prednisone therapy normalized platelet number, but bleeding symptoms did not disappear. Platelet function was severely impaired, since platelet aggregation, ATP release and adhesion to collagen and subendothelial matrix were significantly reduced. Plasma and purified immunoglobulins of the patient reproduced the functional defects in normal platelets. Immunoblotting revealed that patient's plasma contained an antibody reacting with a component of platelets with the same electrophoretic mobility of glycoproteins IIIa of normal platelets. Moreover, patient's plasma inhibited the binding of an anti-GPIIb/IIIa monoclonal antibody to platelet surface. Additional immunosuppressive therapy with prednisone and azathioprine normalized platelet function and induced the disappearance of bleeding symptoms.
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Balduini et al. (1992) conducted a case report in Chronic idiopathic thrombocytopenic purpura (n=1). Prednisone and azathioprine was evaluated on Platelet function and bleeding symptoms. Immunosuppressive therapy with prednisone and azathioprine normalized platelet function and resolved bleeding symptoms in a patient with autoantibodies against platelet glycoprotein IIIa.
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