ITP in childhood: difficulties in the individual treatment.
To date, immunoglobulin preparations and corticosteroids are the most important therapeutic principles in idiopathic thrombocytopenic purpura (ITP). Initial treatment with high-dose immunoglobulins (HD-IgG) as well as the following prednisone therapy, however, were only of short lasting success in three children with newly diagnosed ITP. Recurrent bleeding tendency tempted to combine both drugs. A desired longterm elevation of platelet counts, however, was not achieved. Administration of Anti-Rho (D) to two of the patients was also disappointing. Splenectomy which could not be postponed any longer has already led to 17 and 21 months lasting remissions in 2 patients, respectively. The third patient who required monthly single doses of HD-IgG for 6 months after surgery, is in a partial remission since 27 months now. All types of drug administration--alone, consecutive or even combined--must be considered to defer splenectomy. As experienced in our patients, however, splenectomy still seems to be justified in case even such individually adapted therapeutic approaches fail.
D000293:Adolescent; D001803:Blood Transfusion; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003907:Dexamethasone / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007116:Immunization, Passive; D008297:Male; D010976:Platelet Count; D017713:Platelet Transfusion; D011241:Prednisone / Q000627:therapeutic use*; D011696:Purpura, Thrombocytopenic / Q000628:therapy*; D013156:Splenectomy
D003907:Dexamethasone; D011241:Prednisone