A Survey of 121 patients with Idiopathic Thrombocytopenic Purpura

Abstract

Introduction: Idiopathic Thrombocytopenic Purpura is one of the most common causes of thrombocy-topenia with varius clinical courses and different responses to its treatment modalities. Therefore, we decided to evaluate the clinical course of this disease in our patients.
Methods: In this case series study, from March 1998 to March 2004, we evaluated 121 patients. As a first line of treatment, all of those patients received prednisolone (1mg/kg/day) for 6 weeks. Those who didn't respond or were refractory to prednisolone were candidates for splenectomy, and those who re¬fused these modalities or didn't respond to them were treated with Azathioprine.
Results: 99 patients (81.8%) were female and 22 (18.2%) were male, aged 11-73 years (mean; 28.6). Two patients had immune hemolytic anemia in addition to thrombocytopenia, 4 had systemic lupus erythematosus, and one was HIV positive. %44.6 of patients fully responded to prednisolone, 42 pa¬tients (%34.7) underwent splenectomy and %83.3 of them responsed to it.31 splenectomies were per¬formed in the first three months after diagnosis and 27 (87.1%) of them showed complete response, but 8 (72.7%) of the patients splenectomized after 3 months, had complete response. 14 patients were treated with Azathoprine, 2 of which (14.3%) platelet count normalized.
Conclusion: ITP is more common in females than males. Prednisolone is preferred as a non-invasive treatment with suitable response in comparison to other modalition responses to splenectomy, indicat¬ing that this modality of treatment is useful and effective, especially when performaed in the first 3 months of the diseases.