Pilot study of ascorbic acid for the treatment of refractory immune thrombocytopenic purpura.
The treatment of corticosteroid- and/or splenectomy-refractory immune thrombocytopenic purpura (ITP) includes vinca alkaloids, immunosuppressives, Danazol, intravenous gammaglobulin, and alpha-interferon. However, these treatments have often been associated with toxic side effects. Brox et al. (Br J Haematol 70:341-344, 1988) reported the efficacy of ascorbic acid in the treatment of ITP; the platelet count normalized in seven of 11 patients studied, and tolerance was excellent. However, other investigators have reported less impressive results. These conflicting reports prompted a pilot study of ascorbic acid in 12 patients with refractory ITP. Patients were given 2 g every morning for at least 10 weeks. All have received glucocorticoids, three had undergone splenectomy, and six received other treatments. The maximal increase in platelet count above baseline (i.e., the prestudy platelet count) achieved was < 20,000 in 11 patients and 25,000 in one patient. Therapy was well tolerated, with only two patients complaining of dyspepsia. The results of this study suggest that ascorbic acid is not very effective in patients with refractory ITP.
Jubelirer
S J
SJ
Cancer Care Center, Southern West Virginia Charleston Area Medical Center.
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D000368:Aged; D001205:Ascorbic Acid / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D010976:Platelet Count / Q000187:drug effects*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000188:drug therapy*; D013156:Splenectomy
D000305:Adrenal Cortex Hormones; D001205:Ascorbic Acid