Therapeutic splenectomy in immune thrombocytopenic purpura

The effects of splenectomy in 41 patients managed from 1982 to 1995 at Sher -i-Kashmir Institute of Medical Sciences, Srinagar (Jammu and Kashmir), Ind ia, were studied. Immune thrombocytopenic purpura (ITP) was the main indica tion for therapeutic splenectomy among all the hematologic disorders. The m ean age was 30 years (range 7-64), and the male to female ratio was 1.05:1. The mean platelet count in the preoperative period was 31,751/mm(3) (range 4000-85,000). All patients presented with thrombocytopenia, i.e., platelet count of <100,000/mm(3). In addition, 5 patients presented with anemia, i. e., Hb <10 g%. Among the patients with thrombocytopenia, 30 patients presen ted with counts <50,000/mm3 and II patients presented with counts between 5 0,000-100,000/mm3. None of the patients presented with leukopenia. The morb idity observed was 15% and mortality was 2%. The response to splenectomy wa s complete for thrombocytopenia in 3 patients and partial in 5 patients; 4 patients failed to show any response. In anemic patients, 4 patients showed complete response and 1 patient showed no response. The prognosis was exce llent in patients with platelet count >50,000/mm(3), age <50 years, no conc omitant disease, and disease of shorter duration.