Failure of pulse high-dose dexamethasone in chronic idiopathic immune thrombocytopenia.
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.
Warner
M
M
Department of Pathology, McMaster University, Hamilton, Ontario, Canada.
Wasi
P
P
Couban
S
S
Hayward
C
C
Warkentin
T
T
Kelton
J G
JG
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
D003907:Dexamethasone