Abstract:Nine homosexual patients with immune thrombocytopenia were treated with autologous plasma that had been perfused over silica‐immobilizedStaphylococcus aureusprotein A (SpA). Pretreatment platelet counts ranged from 10,000 to 98,000 cells/mm3(mean: 54,000 cells/mm3). Six patients responded to therapy. Platelets increased by a mean of 95,000 cells/mm3(p150,000 cells/mm3) in four patients. Increased platelet counts are presently sustained in these four individuals after 5 months of follow‐up. Increases in platelet counts significantly correlated with decreases in platelet‐associated IgG (PAIgG), platelet‐directed IgG (PDIgG), and immune complexes (CIC). PAIgG and PDIgG declined by a mean of 67 (p<0.003) and 58 (p<0.007), respectively. CIC decreased by a mean of 37 (p=0.02). Complement was concomitantly activated in all four examined patients. C3a and C5a increased 23‐fold and 2.6‐fold, respectively, while total hemolytic complement decreased by 50. Activated complement components and removal of CIC and IgG thus may contribute to the platelet‐enhancing activity of SpA immunoadsor
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