title: Danazol for the treatment of refractory autoimmune thrombocytopenia in systemic lupus erythematosus.
abstract: OBJECTIVE
  to determine the efficacy of danazol therapy in patients with systemic lupus erythematosus with severe autoimmune thrombocytopenia refractory to other therapies.
  
  
  METHODS
  noncontrolled clinical trial, with a minimum of 8 weeks of therapy, the maximum determined by clinical response.
  
  
  METHODS
  referral-based rheumatology clinic at an army medical center.
  
  
  METHODS
  sequential sample of six patients with systemic lupus erythematosus with severe autoimmune thrombocytopenia refractory to high-dose glucocorticoids. Four patients also failed splenectomy, or cytotoxic drugs, or both.
  
  
  METHODS
  danazol, 200 mg four times per day, was added to the previous therapeutic regimen for at least 2 months.
  
  
  RESULTS
  all six patients had normal platelet counts within 6 weeks of starting danazol treatment. After resolution of thrombocytopenia for at least 1 month, immunosuppressive medications were tapered; one patient had a relapse. During an average follow-up of 12 months, the danazol dose was lowered in the five remaining patients but could not be discontinued without recurrence of thrombocytopenia. During danazol therapy, platelet-bound IgG antibodies and circulating immune complexes did not decrease significantly. Danazol was well tolerated.
  
  
  CONCLUSIONS
  danazol appears to be a useful adjunctive treatment for refractory autoimmune thrombocytopenia associated with systemic lupus erythematosus.
authors: Department of Medicine, Fitzsimons Army Medical Center, Aurora, Colorado.
authors: S G
authors: SG
authors: West
authors: S C
authors: SC
authors: Johnson
mesh_terms: D000328:Adult; D000368:Aged; D000936:Antigen-Antibody Complex / Q000378:metabolism; D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000209:etiology; D001379:Azathioprine / Q000627:therapeutic use; D001792:Blood Platelets / Q000276:immunology; D003131:Combined Modality Therapy; D003613:Danazol / Q000627:therapeutic use*; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011245:Pregnadienes / Q000627:therapeutic use*; D013156:Splenectomy; D013921:Thrombocytopenia / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology
chemical_list: D000936:Antigen-Antibody Complex; D005938:Glucocorticoids; D007074:Immunoglobulin G; D011245:Pregnadienes; D001379:Azathioprine; D003613:Danazol