An elderly patient with acute idiopathic thrombocytopenic purpura (ITP)

An elderly patient with acute-type ITP is reported. An 89-year-old man was admitted to the Department of Physiatrics, Ureshino-Onsen Hospital on July 19, 1991 and commenced rehabilitation treatment. Laboratory data on January 28, 1992 showed decreased platelets (2.8 x 10(4)/mm3). According to this data, the patient was transferred to the Department of Internal Medicine, where laboratory data showed positive occult blood in urine and stool, prolonged bleeding time (over 10 min.) and positive PAIgG (630 ng/10(7) cells). Bone marrow showed an ITP pattern (megakaryocytes 55/mm3). The patient received steroidal pulse therapy (methylprednisolone 1,500 mg/day for 3 days). Subsequently, serum platelet count increased gradually and reached 10 x 10(5)/mm3 in May 1992. We reviewed the case reports of ITP published in Japanese, and conclude that this case was the oldest reported patient with acute-type ITP in Japan.