ORAL HIGH-DOSE METHYLPREDNISOLONE AND INTRAVENOUS IMMUNOGLOBULIN TREATMENTS IN ADULT CHRONIC IDIOPATHIC THROMBOCYTOPENIC PURPURA

Ten adult patient of chronic idiopathic thrombocytopenic purpura (CITP ) used oral prednisone and were treated with seven doses of oral high- dose methylprednisolone (30 mg/kg), Nine of ten patients responded aft er HDMP treatment (pit > 150 x 10(9)/L). Two patients having 8 and 10 years of history achieved long-term remission after first HDMP treatme nt, One unresponsive and one responsive patients did not accept IVIG t reatment as second therapy and lost the follow-up. The remaining six p atients received IVIG (0.5 mg/kg for 5 days) as second therapy after 3 months. Platelet count increased above 150 x 10(9)/L in 4 patients an d between 60-80 x 10(9)/L in 2 patients. The peak platelet counts of b oth therapy users were higher under HDMP than IVIG therapy (252 +/- 11 0.4 vs 174.2 +/- 83.7 x 10(9)/L), but the difference was not significa nt. Responses were transient and returned to pretreatment Values at 14 -30 days, excluding long-term remission of 2 (2/10) patients after HDM P treatment, No side effect was observed. Thus, oral HDMP appears a go od initial therapy for continuous remission in a small ratio of patien ts and a good security for emergency situations and prior to surgery i n adult CITP patients. (C) 1997 Wiley-Liss, Inc.