title: Oral high-dose methylprednisolone and intravenous immunoglobulin treatments in adult chronic idiopathic thrombocytopenic purpura.
abstract: Ten adult patient of chronic idiopathic thrombocytopenic purpura (CITP) used oral prednisone and were treated with seven doses of oral high-dose methylprednisolone (30 mg/kg). Nine of ten patients responded after HDMP treatment (plt > 150 x 10(9)/L). Two patients having 8 and 10 years of history achieved long-term remission after first HDMP treatment. One unresponsive and one responsive patients did not accept IVIG treatment as second therapy and lost the follow-up. The remaining six patients received IVIG (0.5 mg/kg for 5 days) as second therapy after 3 months. Platelet count increased above 150 x 10(9)/L in 4 patients and between 60-80 x 10(9)/L in 2 patients. The peak platelet counts of both therapy users were higher under HDMP than IVIG therapy (252 +/- 110.4 vs 174.2 +/- 83.7 x 10(9)/L), but the difference was not significant. Responses were transient and returned to pretreatment values at 14-30 days, excluding long-term remission of 2 (2/10) patients after HDMP treatment. No side effect was observed. Thus, oral HDMP appears a good initial therapy for continuous remission in a small ratio of patients and a good security for emergency situations and prior to surgery in adult CITP patients.
authors.affiliation: Department of Internal Medicine, Medical Faculty of Ondokuz Mayis University, Samsun, Turkey.
authors.forename: L
authors.initials: L
authors.lastname: Altintop
authors.forename: D
authors.initials: D
authors.lastname: Albayrak
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D010976:Platelet Count / Q000187:drug effects; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous; D008775:Methylprednisolone