title: Immune thrombocytopenic purpura in adults in the last 10 years: single-centre experience.
abstract: BACKGROUND
  Immune thrombocytopenic purpura (ITP) is a benign disease with low morbidity and mortality and frequent remissions that occur spontaneously or in response to first-line treatment with steroids or splenectomy.
  
  
  OBJECTIVE
  The purpose of this study is to describe the clinical outcomes of 170 patients with ITP diagnosed and/or treated in our hospital between 2000 and 2010.
  
  
  RESULTS
  The median age at diagnosis was 47 years. Forty three (25%) were asymptomatic, 65% had minor skin or mucosal bleeding and 10% had significant bleeding from the gastrointestinal or genitourinary system. The median platelet count at diagnosis was 13x10(9)/L (range: 0-98x10(9)/L). Median follow-up of all patients was 13 months. Ninety-five patients had a follow-up longer than 12 months, with median 44 months (range 14-384). Corticosteroids were the initial treatment for 161/170 (95%) patients, 38 (22%) were splenectomized, 25 (14.7%) were treated with intravenous gamma globulins, while 9 did not received any specific treatment. A complete response to initial treatment (prednisone±splenectomy) was achieved in 55/161 (34.2%), a partial response in 90 (55.9%) and no response in 16 (9.9%) patients. In the group of patients with follow-up longer than 1 year; 28 (29%) patients had refractory or unresponsive ITP with a median follow-up of 66 months. All patients with refractory ITP were treated with steroids, 11 were splenctomized, significantly more patients with refractory ITP 12 (43%) were treated with IVIG compared with other ITP patients (16%), p=0.005. The median age of 38 splenectomized patients was 28 years and it is significantly different from the other patients (p<0.001). There were no significant differences in other characteristics between splenctomized or refractory ITP and other patients at diagnosis.
  
  
  CONCLUSIONS
  Our results were similar to results already reported in other similar studies.
authors.affiliation: University Clinic for Haematology, Medical Faculty, Skopje, R. Macedonia.
authors.forename: M
authors.initials: M
authors.lastname: Pavkovic
authors.forename: S
authors.initials: S
authors.lastname: Trpkovska-Terzieva
authors.forename: T
authors.initials: T
authors.lastname: Sotirova
authors.forename: A
authors.initials: A
authors.lastname: Latifi
authors.forename: L
authors.initials: L
authors.lastname: Cevreska
authors.forename: A
authors.initials: A
authors.lastname: Stojanovic
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D012189:Retrospective Studies; D013156:Splenectomy; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous