Adult idiopathic thrombocytopaenic purpura: therapy strategy. Analysis of 30 cases (1991-1995) with a brief review of the literature
Keywords:
adult ediopathic thrombocytoprenic purpura, therapy, responses, evolutionAbstract
Background: We analysed epidemiological data,therapies, clinical efficacy and evolution of patientes with adult idiopathic thrombocytopaenic purpura (ITP).
Patients and methods: A retrospective study of patients with an established diagnosis of ITP, referred to our lnternal Medical Department between 1991 and 1995, was carried out.
Dejinitlons of therapy efficacy and evolution are as follows.· complete remisson platelets > 150000/mm3; continuous complete remission: platelets >150000/mm3 for at least 2 months without therapy partial remission: platelets >50000< 150000/mm3; without therapy response<50000/mm3.
Results: Between 1991 and 1995, 30 patients were admit ted with IPT ( 23female; 7male; median ages: 49,5 years). Corticosteroid therapy was given to 30 patients, 9 achived complete remission; 4 of those were in continuous complete remission; 15 patients had partial remission and 6 failed to achieve a response. 14 patients received gammaglobins intra-venously; 1 achived complete remission; 9 had partial remission and 6 had no response. Only 4 patients were splenectomized; 2 achived complete remission; other were lost for to follow-up.
Four patients were treated with azothioprine; 3 achived partial remission and 1 patient had no response. Danazol was used in 2 patients with no beneftcial effect.. Median follow-up for 24 months revealed: 13 patients had multiple relapses, 4 achieved continuous complete remission and 1 died; 12 patients were lost to follow-up.
Conclusions: Corticosteroid therapy was the most effective therapy in ITP, with 30% of pattents achieving complete remisston in our study.
ln spite of the many different treatment regimes available, 43% of patients had a chronic disease evolution, in accord with the international ITP disease statistics.
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