Failure of pulse high-dose dexamethasone in chronic idiopathic immune thrombocytopenia

✍ Scribed by Warner, M.; Wasi, P.; Couban, S.; Hayward, C.; Warkentin, T.; Kelton, J.G.

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 25 KB
• Volume: 54
• Category: Article
• ISSN: 0361-8609
• DOI: 10.1002/(sici)1096-8652(199704)54:4<267::aid-ajh1>3.0.co;2-t

✦ Synopsis

Idiopathic thrombocytopenic purpura (ITP) is a disorder characterized by increased platelet destruction in the setting of normal megakaryopoiesis. Approximately 20% of patients with ITP are refractory to corticosteroids and splenectomy. Recently, pulse high-dose dexamethasone was reported to be effective in the treatment of chronic ITP in adult patients. We treated 9 patients with severe chronic ITP with monthly high-dose dexamethasone. None of the 9 patients responded with a sustained increase in platelet count. Five of these patients were unable to tolerate the regimen. The failure of high-dose dexamethasone in our hands contrasts with the good results of an earlier publication and suggests that there could be a subset of responders who will require better identification.