title: Combination of high-dose dexamethasone and antiretroviral therapy rapidly improved and induced long-term remission of HIV-related thrombocytopenic purpura.
abstract: We present a case of HIV-related thrombocytopenic purpura (HIV-ITP) successfully treated with high-dose dexamethasone and antiretroviral therapy (ART). Although high-dose dexamethasone is regarded as the first-line therapy in adult patients with non-HIV ITP, there is limited information on treatment of HIV-ITP and long-term prednisone therapy is considered the standard therapy. High-dose dexamethasone is preferable to conventional long-term prednisone therapy, because of fewer side effects mainly due to shorter steroid use. The ART helps achieve long-term remission for HIV-ITP, although this therapy lacks an immediate effect. In our patient, administration of high-dose dexamethasone resulted in rapid rise in platelet count and ART maintained long-term remission of HIV-ITP. The combination therapy is potentially suitable strategy for the treatment of patients with HIV-ITP and severe thrombocytopenia or bleeding.
authors.affiliation: AIDS Clinical Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, 162-0052, Japan.
authors.forename: Takuma
authors.initials: T
authors.lastname: Shindo
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nishijima
authors.forename: Katsuji
authors.initials: K
authors.lastname: Teruya
authors.forename: Daisuke
authors.initials: D
authors.lastname: Mizushima
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Gatanaga
authors.forename: Shinichi
authors.initials: S
authors.lastname: Oka
mesh_terms: D000368:Aged; D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000097:blood* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D011696:Purpura, Thrombocytopenic / Q000188:drug therapy* / Q000821:virology*
chemical_list: D044966:Anti-Retroviral Agents; D003907:Dexamethasone