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Idiopathic Thrombocytopenic Purpura in Children: Should Corticosteroids Be Given?

Idiopathic Thrombocytopenic Purpura in Children: Should Corticosteroids Be Given? Abstract • Life-threatening hemorrhages occur in about 2% of children with idiopathic thrombocytopenic purpura (ITP), the majority during the first month of illness. The administration of corticosteroids to patients with ITP has been shown to improve platelet economy mainly through reduction of phagocytosis in the spleen. Since the risk of a short course of steroids in low dosage is small, it seems reasonable to administer them to patients with ITP during the period of greatest risk. (Am J Dis Child 131:357-359, 1977) References 1. Benham ES, Taft LI: Idiopathic thrombocytopenic purpura in children: Results of steroid therapy and splenectomy . Aust Paediatr J 8:311-317, 1972. 2. Doan CA, Bouroncle BA, Wiseman BK: Idiopathic and secondary thrombocytopenic purpura: Clinical study and evaluation of 381 cases over a period of 28 years . Ann Intern Med 53:861-876, 1960.Crossref 3. Lusher JM, Zuelzer WW: Idiopathic thrombocytopenic purpura in childhood . J Pediatr 68:971-979, 1965.Crossref 4. McClure PD: Idiopathic thrombocytopenic purpura in children: Diagnosis and management . Pediatrics 55:68-74, 1975. 5. Shulman NR, Marder VJ, Weinrach RS: Similarities between known antiplatelet antibodies and the factor responsible for thrombocytopenia in idiopathic purpura: Physiologic, serologic and isotopic studies . Ann NY Acad Sci 124:499-542, 1965.Crossref 6. McMillan R, Longmire RL, Tavassoli M, et al: In vitro platelet phagocytosis by splenic leukocytes in idiopathic thrombocytopenic purpura . N Engl J Med 290:249-251, 1974.Crossref 7. Branehög I, Kutti J, Weinfeld A: Platelet survival and platelet production in idiopathic thrombocytopenic purpura (ITP) . Br J Haematol 27:127-143, 1974.Crossref 8. Branehög I: Platelet kinetics in idiopathic thrombocytopenic purpura (ITP) before and at different times after splenectomy . Br J Haematol 29:413-426, 1975.Crossref 9. Watson-Williams EJ, Macpherson AIS, Davidson S: The treatment of idiopathic thrombocytopenic purpura . Lancet 2:221-226, 1958.Crossref 10. Jiji RM, Firozvi T, Spurling CL: Chronic idiopathic thrombocytopenic purpura . Arch Intern Med 132:380-383, 1973.Crossref 11. Thompson RL, Moore RA, Hess CE, et al: Idiopathic thrombocytopenic purpura . Arch Intern Med 130:730-734, 1972.Crossref 12. Schulman I: Diagnosis and treatment: Management of idiopathic thrombocytopenic purpura . Pediatrics 33:979-980, 1964. 13. Simons SM, Main CA, Yaish HM, et al: Idiopathic thrombocytopenic purpura in children . J Pediatr 87:16-22, 1975.Crossref 14. Robson HN, Duthie JJR: Capillary resistance and adrenocortical activity . Br Med J 2:971-977, 1950.Crossref 15. Faloon WW, Greene RW, Lozner EL: The hemostatic defect in thrombocytopenia as studied by the use of ACTH and cortisone . Am J Med 13:12-20, 1952.Crossref 16. Menkin V: Further studies on mechanism of increased capillary permeability in inflammation with the aid of cortisone and ACTH . Proc Soc Exp Biol Med 77:592-597, 1951.Crossref 17. Labram C: Étude de l'action vaso-constrictrice de la prednisone . Rev Fr Étud Clin Biol 8:765-772, 1963. 18. Harrington WJ, Minnich V, Arimura G: The autoimmune thrombocytopenias . Prog Hematol 1:166-192, 1956. 19. Butler WT, Rossen RD: Effects of corticosteroids on immunity in man: I. Decreased serum IgG concentration caused by three or five days of high doses of methylprednisolone . J Clin Invest 52:2629-2640, 1973.Crossref 20. Claman HN: Corticosteroids and lymphoid cells . N Engl J Med 287:388-397, 1972.Crossref 21. Handin RI, Stossel TP: Phagocytosis of antibody-coated platelets by human granulocytes . N Engl J Med 290:989-993, 1974.Crossref 22. McMillan R, Longmire RL, Yelenosky R, et al: Immunoglobulin synthesis in vitro by splenic tissue in idiopathic thrombocytopenic purpura . N Engl J Med 286:681-684, 1972.Crossref 23. Karpatkin S, Strick N, Siskind GW: Detection of splenic anti-platelet antibody synthesis in idiopathic autoimmune thrombocytopenic purpura (ATP) . Br J Haematol 23:167-176, 1972.Crossref 24. Walker JH, Walker W: Idiopathic thrombocytopenic purpura in childhood . Arch Dis Child 36:649-657, 1961.Crossref 25. Lammi AT, Lovric VA: Idiopathic thrombocytopenic purpura: An epidemiologic study . J Pediatr 83:31-36, 1973.Crossref 26. Komrower GM, Watson GH: Prognosis in idiopathic thrombocytopenic purpura of childhood . Arch Dis Child 29:502-506, 1954.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Idiopathic Thrombocytopenic Purpura in Children: Should Corticosteroids Be Given?

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References (32)

Publisher
American Medical Association
Copyright
Copyright © 1977 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1977.02120160111018
Publisher site
See Article on Publisher Site

Abstract

Abstract • Life-threatening hemorrhages occur in about 2% of children with idiopathic thrombocytopenic purpura (ITP), the majority during the first month of illness. The administration of corticosteroids to patients with ITP has been shown to improve platelet economy mainly through reduction of phagocytosis in the spleen. Since the risk of a short course of steroids in low dosage is small, it seems reasonable to administer them to patients with ITP during the period of greatest risk. (Am J Dis Child 131:357-359, 1977) References 1. Benham ES, Taft LI: Idiopathic thrombocytopenic purpura in children: Results of steroid therapy and splenectomy . Aust Paediatr J 8:311-317, 1972. 2. Doan CA, Bouroncle BA, Wiseman BK: Idiopathic and secondary thrombocytopenic purpura: Clinical study and evaluation of 381 cases over a period of 28 years . Ann Intern Med 53:861-876, 1960.Crossref 3. Lusher JM, Zuelzer WW: Idiopathic thrombocytopenic purpura in childhood . J Pediatr 68:971-979, 1965.Crossref 4. McClure PD: Idiopathic thrombocytopenic purpura in children: Diagnosis and management . Pediatrics 55:68-74, 1975. 5. Shulman NR, Marder VJ, Weinrach RS: Similarities between known antiplatelet antibodies and the factor responsible for thrombocytopenia in idiopathic purpura: Physiologic, serologic and isotopic studies . Ann NY Acad Sci 124:499-542, 1965.Crossref 6. McMillan R, Longmire RL, Tavassoli M, et al: In vitro platelet phagocytosis by splenic leukocytes in idiopathic thrombocytopenic purpura . N Engl J Med 290:249-251, 1974.Crossref 7. Branehög I, Kutti J, Weinfeld A: Platelet survival and platelet production in idiopathic thrombocytopenic purpura (ITP) . Br J Haematol 27:127-143, 1974.Crossref 8. Branehög I: Platelet kinetics in idiopathic thrombocytopenic purpura (ITP) before and at different times after splenectomy . Br J Haematol 29:413-426, 1975.Crossref 9. Watson-Williams EJ, Macpherson AIS, Davidson S: The treatment of idiopathic thrombocytopenic purpura . Lancet 2:221-226, 1958.Crossref 10. Jiji RM, Firozvi T, Spurling CL: Chronic idiopathic thrombocytopenic purpura . Arch Intern Med 132:380-383, 1973.Crossref 11. Thompson RL, Moore RA, Hess CE, et al: Idiopathic thrombocytopenic purpura . Arch Intern Med 130:730-734, 1972.Crossref 12. Schulman I: Diagnosis and treatment: Management of idiopathic thrombocytopenic purpura . Pediatrics 33:979-980, 1964. 13. Simons SM, Main CA, Yaish HM, et al: Idiopathic thrombocytopenic purpura in children . J Pediatr 87:16-22, 1975.Crossref 14. Robson HN, Duthie JJR: Capillary resistance and adrenocortical activity . Br Med J 2:971-977, 1950.Crossref 15. Faloon WW, Greene RW, Lozner EL: The hemostatic defect in thrombocytopenia as studied by the use of ACTH and cortisone . Am J Med 13:12-20, 1952.Crossref 16. Menkin V: Further studies on mechanism of increased capillary permeability in inflammation with the aid of cortisone and ACTH . Proc Soc Exp Biol Med 77:592-597, 1951.Crossref 17. Labram C: Étude de l'action vaso-constrictrice de la prednisone . Rev Fr Étud Clin Biol 8:765-772, 1963. 18. Harrington WJ, Minnich V, Arimura G: The autoimmune thrombocytopenias . Prog Hematol 1:166-192, 1956. 19. Butler WT, Rossen RD: Effects of corticosteroids on immunity in man: I. Decreased serum IgG concentration caused by three or five days of high doses of methylprednisolone . J Clin Invest 52:2629-2640, 1973.Crossref 20. Claman HN: Corticosteroids and lymphoid cells . N Engl J Med 287:388-397, 1972.Crossref 21. Handin RI, Stossel TP: Phagocytosis of antibody-coated platelets by human granulocytes . N Engl J Med 290:989-993, 1974.Crossref 22. McMillan R, Longmire RL, Yelenosky R, et al: Immunoglobulin synthesis in vitro by splenic tissue in idiopathic thrombocytopenic purpura . N Engl J Med 286:681-684, 1972.Crossref 23. Karpatkin S, Strick N, Siskind GW: Detection of splenic anti-platelet antibody synthesis in idiopathic autoimmune thrombocytopenic purpura (ATP) . Br J Haematol 23:167-176, 1972.Crossref 24. Walker JH, Walker W: Idiopathic thrombocytopenic purpura in childhood . Arch Dis Child 36:649-657, 1961.Crossref 25. Lammi AT, Lovric VA: Idiopathic thrombocytopenic purpura: An epidemiologic study . J Pediatr 83:31-36, 1973.Crossref 26. Komrower GM, Watson GH: Prognosis in idiopathic thrombocytopenic purpura of childhood . Arch Dis Child 29:502-506, 1954.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Mar 1, 1977

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