Cas CliniquePurpura thrombopénique auto-immun et syndromes apparentés au SIDA. Préparation à la chirurgie par les immunoglobulinesAuto-immune thrombocytopaenic purpura and AIDS-like syndromes. Preparing the patient for surgery with immunoglobulins

A case is reported of autoimmune thrombocytopaenic purpura in a narcotics addict with antibodies against human immune deficiency virus (HIV). Three points need stressing : 1) HIV is a new viral cause of autoimmune thrombocytopaenic purpura, the first report of which dates from 1985; 2) this bleeding diathesis may be seen more often in normal anaesthetic practice because of the frequent association of intravenous toxicomania with anti-HIV antibodies and thrombocytopaenia. Thus, of the thirty cases detected in two years and followed by our Department of haematology, two were operated on in the orthopaedic unit; 3) the use of intravenous human gammaglobulins is of great interest each time the clinical situation requires a rapid increase in the platelet count, such as before surgery. The usual dose is 400 mg · kg−1 · j−1 for five consecutive days. The response to immunoglobulins is seen in two or three days; their efficacy, in the case described, lasted for five to seven days, this including the postoperative time. Booster doses were followed by a quick increase in platelet count.