Response to splenectomy in idiopathic thrombocytopenic purpura: prognostic value of the clinical and laboratory evaluation.
Sixteen patients with chronic idiopathic thrombocytopenic purpura underwent splenectomy after failure of steroid therapy. The average time of follow-up was 69 months. Immediately after splenectomy, complete response (platelets above 150 x 10(9)/l) was obtained by 68% of patients while 25% had partial response (platelets from 50 to 150 x 10(9)/l) and only in 1 patient splenectomy failed. During the long-term follow-up, 2 patients relapsed 9 and 20 years, respectively, after splenectomy (20% of non-responders). Partial recurrence of thrombocytopenia (partial response) was observed in 33% of the patients. The persistent complete response rate was then 47%. The young patient age appears to be the only positive predictive factor both for short-term and long-term response to splenectomy. The platelet recovery rate and postsplenectomy thrombocytosis are also early features of lasting response. Positive serum and platelet-associated immunoglobulins became negative after splenectomy, but there is no correlation with clinical response.
Fabris
F
F
University of Padua Medical School, Institute of Medical Semeiotics, Padova, Italy.
Zanatta
N
N
Casonato
A
A
Randi
M L
ML
Luzzatto
G
G
Girolami
A
A
D000328:Adult; D001792:Blood Platelets / Q000276:immunology; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D011696:Purpura, Thrombocytopenic / Q000097:blood / Q000188:drug therapy / Q000601:surgery*; D013156:Splenectomy
D007074:Immunoglobulin G; D011241:Prednisone