[Transient normalization of the thrombocyte count in chronic idiopathic thrombocytopenia during pneumonia]

A patient is described with severe chronic idiopathic thrombocytopenic purpura. The platelet count was constantly below 20 X 10(9) Tc/L. Therapy with steroids, immunoglobulin-infusion with and without steroids, vincristine and danazol produced no improvement of the thrombocytopenia. During acute pneumonia a transient remission of the platelet count was observed. Antibodies against thrombocytes and immune complexes were not detected. The level of platelet-associated IgG was increased before and after infection but was only slightly elevated when platelet count was normal. An attempt to imitate the infection by vaccinating the patient with pneumovac with a view to later splenectomy did not change the platelet count. This observation confirms the hypothesis that elevation of platelet count during infection is due to decreased production of platelet autoantibody. Even severe forms of ITP are potentially reversible.