The response to high-dose intravenous immunoglobulin or steroids is not predictive of outcome after splenectomy in adults with autoimmune thrombocytopenic purpura

The response to high-dose intravenous immunoglobulin (IVIg) was recently re ported to be predictive of outcome after splenectomy in patients with autoi mmune thrombocytopenic purpura (AITP). We analysed the records of 75 adults with chronic AITP who received IVIg and subsequently underwent splenectomy . There was no significant difference in the response rate to splenectomy a ccording to whether or not patients had responded to IVIg (81% v 67%, P=0.3 6). Age, the time from diagnosis to splenectomy, and the response to steroi ds were also not significantly associated with outcome after splenectomy. T hese results indicate that the response to IVIg or steroids is not predicti ve of the efficacy of splenectomy.