A case of two-jaw surgery under high-dose gamma-globulin therapy for a patient with ITP

A case of two-jaw surgery applied horseshoe Le Fort I osteotomy and sagittal split ramus osteotomy with idiopathic thrombocytopenic purpura (ITP) in a 22-year-old Japanese woman with class III malocclusion, facial asymmetry, and anterior apertognathia is reported. A low platelet count of 4.5 × 104/μL was found at preoperative laboratory test. ITP was diagnosed, and the patient was given preoperative high-dose intravenous gamma-globulin therapy for 5 days. On the day of the operation, the platelet count was 13.5 × 104/μL. Horseshoe Le Fort I osteotomy and sagittal split ramus osteotomy were performed. The amount of perioperative blood loss was 350 mL. There was no abnormal bleeding after surgery, and the patient's postoperative course was uneventful.