Effect of high-dose dexamethasone in prednisone-resistant autoimmune thrombocytopenic purpura (ITP).
This study investigated whether high-dose dexamethasone pulse therapy could bring about a remission in adult chronic idiopathic thrombocytopenic purpura (ITP) patients who had not achieved a remission on the usual prednisone therapy. Newly diagnosed patients with ITP received the usual prednisone therapy, 1 mg/kg/day, for 3 weeks, after which period the dosage was tapered off. If after 6 weeks of treatment the platelets were less than 50 x 10(9)/l the prednisone therapy was considered a failure and 200 mg dexamethasone i.v. was given on 3 consecutive days. Six of the twenty-five patients with newly diagnosed ITP treated according to this protocol achieved a sufficient response with prednisone therapy. Nineteen patients were resistant to or relapsed during prednisone therapy and were treated with high-dose dexamethasone. Four of these nineteen patients showed a sufficient response. Three are still in remission. As no serious adverse effects were observed, high-dose dexamethasone therapy can be considered before splenectomy in prednisone- resistant ITP patients.
Dubbeld
P
P
Department of Internal Medicine, Sint Elisabeth Hospital, Tilburg, The Netherlands.
van der Heul
C
C
Hillen
H F
HF
D000293:Adolescent; D000328:Adult; D000368:Aged; D002985:Clinical Protocols; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D004351:Drug Resistance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy*; D012008:Recurrence; D012074:Remission Induction
D003907:Dexamethasone; D011241:Prednisone