To investigate the relationship between the hematological outcomes of splenectomy and the abnormal cellular immunity of the spleen in patients with immune thrombocytopenic purpura (ITP).

With the monoclonal antibody of the anti-human CD3, CD4, CD8 and the polyclonal antibody of the anti-human S100, the expression of the CD3⁺, CD4⁺, CD8⁺ and S100+cell in the specimens of the spleen tissue were detected by the immuohistochemistry method from 33 ITP patients who had response to splenectomy (group A) and 14 cases who had no response to splenectomy (group B). The specimens of the spleen tissue of 12 cases who underwent emergency splenectomy for traumatic rupture of spleen was served as the control group (group C). The percentages of the positive staining cells around the periarterial lymphatic sheath(PALS) of the spleen were counted under the microscope. The ratio of the percentage of CD4⁺ cell and CD8⁺ cell was calculated. The differences in the percentages of CD3, CD4, CD8 and S100 positive staining cells, as well as CD4⁺/CD8⁺ ratio, were analyzed among the three groups.

No significant difference of the percentage of CD3⁺ cell and CD4⁺ cell was found among the three groups. The percentage of the CD8⁺ cell in the group A was significantly higher than that in the group B(P=0.001) and group C(P<0.01). And CD4⁺/CD8⁺ ratio in the group C was also higher than that in the group A (P=0.001) and group B(P=0.01). There was significant difference in the percentages of the S100⁺ cell between group A and the group B(P=0.015).

Abnormal cellular immunity of spleen is found in patients with ITP. There is close relationship between the hematological outcomes of splenectomy and the abnormal cellular immunity of the spleen.