Idiopathic thrombocytopenic purpura is an acquired chronic autoimmune disease .Treatment when
indicated is usually by corticosteroids,then splenectomy if no acceptable response,with variable
response rate to both types of treatment.
To look for the effects of certain variables on the type of response to steroid therapy in patients with
adult idiopathic thrombocytopenic purpura, and to study the outcome of splenectomy in relation to
previous steroid therapy.
A prospective study on 80 patients, presented with bleeding and a platelet count of ≤ 30 X 109 / L.
Initially treated with prednisolone and the response was studied in relation to gender , age , duration of
bleeding and platelet count on presentation. Patients who failed to maintain permanent complete
remission were advised to have splenectomy.
Of the 80 patients, 62 (77.5 %) were females and 18 (22.5%) were males. Mean age was 23 ± 10.1
years. Ten (12.5%) patients only had permanent complete remission after steroid therapy. While 70
(87.5%) patints failed. Response to steroid therapy was significantly related to duration of bleeding but
not to gender, age and platelet count. Thirty seven (46%) patients underwent splenectomy, permanent
complete remission were achieved in 29 (78.2%).
1. Duration of bleeding of ≤ 3 weeks is a good predictor of successful steroid therapy.
2. Results after splenectomy is not related to previos steroid therapy