title: Failure of pulse high-dose dexamethasone in chronic idiopathic immune thrombocytopenia.
abstract: Idiopathic thrombocytopenic purpura (ITP) is a disorder characterized by increased platelet destruction in the setting of normal megakaryopoiesis. Approximately 20% of patients with ITP are refractory to corticosteroids and splenectomy. Recently, pulse high-dose dexamethasone was reported to be effective in the treatment of chronic ITP in adult patients. We treated 9 patients with severe chronic ITP with monthly high-dose dexamethasone. None of the 9 patients responded with a sustained increase in platelet count. Five of these patients were unable to tolerate the regimen. The failure of high-dose dexamethasone in our hands contrasts with the good results of an earlier publication and suggests that there could be a subset of responders who will require better identification.
authors.affiliation: Department of Pathology, McMaster University, Hamilton, Ontario, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Warner
authors.forename: P
authors.initials: P
authors.lastname: Wasi
authors.forename: S
authors.initials: S
authors.lastname: Couban
authors.forename: C
authors.initials: C
authors.lastname: Hayward
authors.forename: T
authors.initials: T
authors.lastname: Warkentin
authors.forename: J G
authors.initials: JG
authors.lastname: Kelton
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013920:Thrombocythemia, Essential / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D003907:Dexamethasone