title: Treatment of patients with immune thrombocytopenia admitted to the emergency room.
abstract: Immune thrombocytopenia (ITP) is the most frequent cause of acquired thrombocytopenia. In adult ITP patients, corticosteroids and intravenous immunoglobulin (IVIg) are used as first-line treatment. The aim of the present study was to investigate retrospectively the demographic and etiologic characteristics of patients with ITP admitted to the emergency room at our hospital. Seventy-five adult patients with ITP were included, and demographic data, bleeding characteristics, etiologic features and responses to treatments were evaluated retrospectively. Fifty-six patients (75 %) were female, and the median age was 43 years. Eighteen patients had a history of ITP, whereas in 57, thrombocytopenia was identified for the first time. During admission, the median platelet count was 5 × 10(9)/L. Cutaneous and/or mucosal bleeding was the most common clinical feature. High-dose dexamethasone was administered in 60 episodes, whereas IVIg and conventional-dose methylprednisolone were used in nine and six episodes, respectively. The overall response rate of the entire cohort following first-line treatments was 67 %, and complete remission was achieved in 31 patients, 19 patients achieved partial remission, and 25 patients were non-responders. In cases with life-threatening bleeding, concomitant infection, post-traumatic bleeding and need for emergency surgery, IVIg can be used as the first line of treatment option in addition to platelet transfusions.
authors.affiliation: Division of General Internal Medicine, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, Istanbul University, Fatih, Istanbul, Turkey.
authors.forename: Işıl
authors.initials: I
authors.lastname: Bavunoğlu
authors.affiliation: Division of Hematology, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, Istanbul University, Fatih, Istanbul, Turkey.
authors.forename: Ahmet Emre
authors.initials: AE
authors.lastname: Eşkazan
authors.affiliation: Division of Hematology, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, Istanbul University, Fatih, Istanbul, Turkey. mcemar68@yahoo.com.
authors.forename: Muhlis Cem
authors.initials: MC
authors.lastname: Ar
authors.affiliation: Division of General Internal Medicine, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, Istanbul University, Fatih, Istanbul, Turkey.
authors.forename: Mahir
authors.initials: M
authors.lastname: Cengiz
authors.affiliation: Division of General Internal Medicine, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, Istanbul University, Fatih, Istanbul, Turkey.
authors.forename: Serap
authors.initials: S
authors.lastname: Yavuzer
authors.affiliation: Division of Hematology, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, Istanbul University, Fatih, Istanbul, Turkey.
authors.forename: Ayşe
authors.initials: A
authors.lastname: Salihoğlu
authors.affiliation: Division of Hematology, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, Istanbul University, Fatih, Istanbul, Turkey.
authors.forename: Şeniz
authors.initials: Ş
authors.lastname: Öngören
authors.affiliation: Division of General Internal Medicine, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, Istanbul University, Fatih, Istanbul, Turkey.
authors.forename: Aydın
authors.initials: A
authors.lastname: Tunçkale
authors.affiliation: Division of Hematology, Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, Istanbul University, Fatih, Istanbul, Turkey.
authors.forename: Teoman
authors.initials: T
authors.lastname: Soysal
mesh_terms: D000328:Adult; D003907:Dexamethasone / Q000627:therapeutic use; D004636:Emergency Service, Hospital; D005260:Female; D006470:Hemorrhage; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007239:Infections; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D017713:Platelet Transfusion; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications / Q000628:therapy*; D012074:Remission Induction; D012189:Retrospective Studies
chemical_list: D016756:Immunoglobulins, Intravenous; D003907:Dexamethasone; D008775:Methylprednisolone
keywords: Conventional-dose methylprednisolone; Emergency room; High-dose dexamethasone; Immune thrombocytopenia; Intravenous immunoglobulin