A 5-year-old girl, diagnosed to have idiopathic thrombocytopenic purpura (ITP), was admitted to our hospital, because a cyclic change of platelet counts was noticed. Her platelet counts fluctuated cyclically from 18×103/μl to 205×103/μl in 13∼15 days. Examination of the bone marrow revealed icncrease in immature form of megakaryocytes. Immunofluorescence technique detected platelet-associated IgG (PAIgG) in thrombocytopenic phase. After a high-dose intravenous immunoglobulin therapy, the platelet count and PAIgG level returned to normal for about 3 months. However the periodicity of platelet count recurred thereafter.
These observations suggested that the mechanism of thrombocytopenia in this patients would be chiefly ascribable to the same type of immune-mediated platelet destruction as ITP.
