Liposteroid therapy for chronic childhood idiopathic thrombocytopenic purpura: Two case reports

We treated two children with chronic idiopathic thrombocytopenic purpura (I TP) with an intravenous lipid emulsion containing dexamethasone (liposteroi d), which is considered to distribute to specific target sites and result i n a reduction of systemic side effects compared with oral dexamethasone. Or al glucocorticoids or intermittent intravenous immunoglobulin increased pla telet count in both cases, the efficacy of the both therapy was transient. However, the intermittent administration of liposteroid brought about a com plete remission in one case and a partial but highly significant response i n the other. No substantial side effects were observed in both cases, in 19 94, Anderson reported the successful use of oral high dose dexamethasone in the treatment of chronic ITP [Andersen J.C. (1994). N Engl J Med, 330, 156 0-4] and since then several clinical trials have been undertaken. The resul ts have not been uniform, however, and intolerable side effects have been r ecorded in some instances, especially in children. In this respect, the dru g delivery system utilized with liposteroid might minimize the drawback of oral high dose dexamethasone. Our observations indicate that liposteroid mi ght be a useful therapeutic option for chronic ITP and suggest that control led clinical trials are warranted.