title: Corticosteroid in the treatment of moderate to severe thrombocytopenia due to leptospirosis.
abstract: BACKGROUND
  Thrombocytopenia is associated with a bad prognosis in Leptospirosis.
  
  
  OBJECTIVE
  We investigated the effect of corticosteroids to improve thrombocytopenia due to leptospirosis.
  
  
  METHODS
  In a clinical trial, all patients admitted with leptospirosis in Razi Hospital of Ghaemshahr, north of Iran were enrolled in a 2-year study. Totally, 56 patients with moderate to severe thrombocytopenia were randomized to control and treatment groups. The treatment group received corticosteroid (prednisolone 1 mg/kg/day for maximum one week) in addition to the standard antibiotic therapy.
  
  
  RESULTS
  There was no significant difference regarding age and gender between the two groups (P = 0.254, P = 0.789, respectively). The mean duration to improve thrombocytopenia was 4.41 ± 0.197 days in the treatment group and 5.72 ± 0.318 days in the control group, which was significantly different (P = 0.003). Duration of hospitalization in the treatment group was 5.24 ± 0.244 days and 6.23 ± 0.329 days in the control group, which was significantly different (P = 0.028). The two groups had no significant difference regarding mortality, intubation, level of platelet, duration of ICU admission and pulmonary, renal or hepatic involvement.
  
  
  CONCLUSIONS
  Corticosteroid therapy decreased the length of hospitalization only in severe subgroup thrombocytopenia, but not in the moderate subgroup.
authors.affiliation: Department of Infectious Diseases and Tropical Medicine, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Shahriar
authors.initials: S
authors.lastname: Alian
authors.affiliation: Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Hasan
authors.initials: H
authors.lastname: Asghari
authors.affiliation: Department of Infectious Diseases and Tropical Medicine, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Narges
authors.initials: N
authors.lastname: Najafi
authors.affiliation: Department of Infectious Diseases and Tropical Medicine, Antimicrobial Resistance Research Center, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Davoudi
authors.affiliation: Department of Biostatistics, Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, IR Iran.
authors.forename: Jamshid
authors.initials: J
authors.lastname: Yazdani
keywords: Corticosteroids; Leptospirosis; Thrombocytopenia