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Failure of pulse high‐dose dexamethasone in chronic idiopathic immune thrombocytopenia
Author(s) -
Warner M.,
Wasi P.,
Couban S.,
Hayward C.,
Warkentin T.,
Kelton J.G.
Publication year - 1997
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/(sici)1096-8652(199704)54:4<267::aid-ajh1>3.0.co;2-t
Subject(s) - medicine , dexamethasone , splenectomy , immune thrombocytopenia , thrombocytopenic purpura , refractory (planetary science) , regimen , platelet , eltrombopag , etiology , gastroenterology , spleen , physics , astrobiology
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. Am. J. Hematol. 54:267–270, 1997. © 1997 Wiley‐Liss, Inc.