Chambrelant I, Perruisseau-Carrier J, Noël G, Herbrecht R and Antoni D
CIdiopathic thrombocytopenic purpura is an acquired immune disorder char-
acterized by immune-mediated destruction of platelets and their precursors,
megakaryocytes. Bleedings are the main risks, and it results in a lower quality
of life. A 45-year-old man presenting with idiopathic thrombocytopenic pur-
pura received successive treatments. However, he became resistant to medi-
cal treatments, and he required a splenectomy. Two years later, the patient
relapsed, and despite the use of thrombopoiesis stimulating agents, the im-
provement was transitory. A CT scan showed an accessory spleen that could
explain this refractory idiopathic thrombocytopenic purpura. Splenectomy
was contra-indicated, and irradiation at the dose of 10Gy in 10 daily fractions
of 1 Gy was performed. In the absence of platelets increase, we proposed
second irradiation. This case of accessory spleen irradiation is the opportu-
nity to review the role of radiotherapy in idiopathic thrombocytopenic purpura
and discuss its place compared to the new efficient treatment.