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Idiopathic Thrombocytopenic Purpura: Long-term Results of Treatment and the Prognostic Significance of Response to Corticosteroids

Idiopathic Thrombocytopenic Purpura: Long-term Results of Treatment and the Prognostic... Abstract Long-term response to corticosteroid therapy and splenectomy was evaluated in 66 adults with idiopathic thrombocytopenic purpura (ITP). In 75% of 57 patients, a rise in platelet count was observed during administration of corticosteroids. In 49% of the 57, platelet counts of greater than 50,000/cu mm were documented four months after cessation of treatment, and in 37% a sustained remission throughout follow-up periods of 1 to 18 years was seen. Splenectomy produced good or excellent responses in 83% of 35 patients evaluated four months after operation and in all but two patients remission has been sustained during follow-up periods of 1 to 25 years. Prognosis based upon response to the initial course of corticosteroid treatment appears to be more reliable than that based upon duration of symptoms prior to treatment. References 1. Sandusky WR, Leavell BS, Benjamin BI: Splenectomy: Indications and results in hematologic disorders. Ann Surg 159:695-710, 1964.Crossref 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. Block GE, Evans R, Zajtchuk R: Splenectomy for idiopathic thrombocytopenic purpura. Arch Surg 92:484-489, 1966.Crossref 4. Dameshek W, Rubio F, Mahoney JP, et al: Treatment of idiopathic thrombocytopenic purpura with prednisone. JAMA 166:1805-1815, 1958.Crossref 5. Myers MC: Results of treatment in 71 patients with idiopathic thrombocytopenic purpura. Amer J Med Sci 242:295-302, 1961.Crossref 6. Carpenter AF, Wintrobe MM, Fuller EA, et al: Treatment of idiopathic thrombocytopenic purpura. JAMA 171:1911-1916, 1959.Crossref 7. Hirsch EO, Dameshek W: Idiopathic thrombocytopenia. Arch Intern Med 88:701-728, 1951.Crossref 8. Bunting WL, Kiely JM, Campbell DC: Idiopathic thrombocytopenic purpura. Arch Intern Med 108:733-738, 1961.Crossref 9. Brecher G, Schneiderman M, Cronkite E: The reproducibility and constancy of the platelet count. Amer J Clin Path 23:15-26, 1953. 10. Brittin G, Dew SA, Elvi KF: Automatic platelet counting—a comparison of electronic and optical techniques. Lab Med 2:46-48, 1971. 11. Bernard J, Soulier JP: Sur une nouvelle varieta de dystrophie thrombocytaire hemorragiapara congenitale. Sem Hop Paris 24:3217, 1948. 12. Dameshek W: Controversy in idiopathic thrombocytopenic purpura. JAMA 173:1025-1029, 1960.Crossref 13. Scharfman WB, Hosley HF, Hawkins T, et al: Idiopathic thrombocytopenic purpura. JAMA 172:1875-1884, 1960.Crossref 14. Shulman MR, Weinrach RS, Libre EP, et al: The role of the reticuloendothelial system in the pathogenesis of idiopathic thrombocytopenic purpura. Trans Assoc Amer Phys 78:374-390, 1965. 15. McMillan R, Longmire R, Yelenosky R, et al: Platelet-binding antibodies produced in vitro by ITP spleens. J Clin Invest 50:65a, 1971. 16. Karpatkin S, Strick M, Siskind GW: Detection of splenic anti-platelet antibody synthesis in (idiopathic) autoimmune thrombocytopenic purpura (STP). Clin Res 19:422, 1971. 17. McMillan RM, Longmire RL, Yelenosky R, et al: Immunoglobulin synthesis in vitro by splenic tissue in idiopathic thrombocytopenic purpura. New Eng J Med 286:681-684, 1972.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Idiopathic Thrombocytopenic Purpura: Long-term Results of Treatment and the Prognostic Significance of Response to Corticosteroids

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Publisher
American Medical Association
Copyright
Copyright © 1972 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1972.03650050058010
Publisher site
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Abstract

Abstract Long-term response to corticosteroid therapy and splenectomy was evaluated in 66 adults with idiopathic thrombocytopenic purpura (ITP). In 75% of 57 patients, a rise in platelet count was observed during administration of corticosteroids. In 49% of the 57, platelet counts of greater than 50,000/cu mm were documented four months after cessation of treatment, and in 37% a sustained remission throughout follow-up periods of 1 to 18 years was seen. Splenectomy produced good or excellent responses in 83% of 35 patients evaluated four months after operation and in all but two patients remission has been sustained during follow-up periods of 1 to 25 years. Prognosis based upon response to the initial course of corticosteroid treatment appears to be more reliable than that based upon duration of symptoms prior to treatment. References 1. Sandusky WR, Leavell BS, Benjamin BI: Splenectomy: Indications and results in hematologic disorders. Ann Surg 159:695-710, 1964.Crossref 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. Block GE, Evans R, Zajtchuk R: Splenectomy for idiopathic thrombocytopenic purpura. Arch Surg 92:484-489, 1966.Crossref 4. Dameshek W, Rubio F, Mahoney JP, et al: Treatment of idiopathic thrombocytopenic purpura with prednisone. JAMA 166:1805-1815, 1958.Crossref 5. Myers MC: Results of treatment in 71 patients with idiopathic thrombocytopenic purpura. Amer J Med Sci 242:295-302, 1961.Crossref 6. Carpenter AF, Wintrobe MM, Fuller EA, et al: Treatment of idiopathic thrombocytopenic purpura. JAMA 171:1911-1916, 1959.Crossref 7. Hirsch EO, Dameshek W: Idiopathic thrombocytopenia. Arch Intern Med 88:701-728, 1951.Crossref 8. Bunting WL, Kiely JM, Campbell DC: Idiopathic thrombocytopenic purpura. Arch Intern Med 108:733-738, 1961.Crossref 9. Brecher G, Schneiderman M, Cronkite E: The reproducibility and constancy of the platelet count. Amer J Clin Path 23:15-26, 1953. 10. Brittin G, Dew SA, Elvi KF: Automatic platelet counting—a comparison of electronic and optical techniques. Lab Med 2:46-48, 1971. 11. Bernard J, Soulier JP: Sur une nouvelle varieta de dystrophie thrombocytaire hemorragiapara congenitale. Sem Hop Paris 24:3217, 1948. 12. Dameshek W: Controversy in idiopathic thrombocytopenic purpura. JAMA 173:1025-1029, 1960.Crossref 13. Scharfman WB, Hosley HF, Hawkins T, et al: Idiopathic thrombocytopenic purpura. JAMA 172:1875-1884, 1960.Crossref 14. Shulman MR, Weinrach RS, Libre EP, et al: The role of the reticuloendothelial system in the pathogenesis of idiopathic thrombocytopenic purpura. Trans Assoc Amer Phys 78:374-390, 1965. 15. McMillan R, Longmire R, Yelenosky R, et al: Platelet-binding antibodies produced in vitro by ITP spleens. J Clin Invest 50:65a, 1971. 16. Karpatkin S, Strick M, Siskind GW: Detection of splenic anti-platelet antibody synthesis in (idiopathic) autoimmune thrombocytopenic purpura (STP). Clin Res 19:422, 1971. 17. McMillan RM, Longmire RL, Yelenosky R, et al: Immunoglobulin synthesis in vitro by splenic tissue in idiopathic thrombocytopenic purpura. New Eng J Med 286:681-684, 1972.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Nov 1, 1972

References