Document Detail


Chronic ITP: analysis of various factors at presentation which predict failure to first line treatment and their response to second line therapy.
MedLine Citation:
PMID:  17432016     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To observe the significance of various factors in chronic idiopathic thrombocytopenic purpura (ITP) which predict the response of first line (corticosteroids) and second line therapy (splenectomy) and to evaluate their response to second line therapy. METHODS: This was a descriptive, prospective study conducted from August 2004 till January 2006. Patients of all age groups and both genders with diagnosis of chronic ITP were included. Treatment protocol and criteria for response assessment was explained. RESULTS: During 17 months period, 86 patients with chronic ITP were analyzed. Non-responders to first line therapy were 74 patients who ultimately required splenectomy. Complete response (CR) was had in 37 (50.7%) patients, 10 (13.7%) and 27 (36.5%) had partial response (PR) and no response (NR) respectively. Analysis of variables like younger age, sex and low platelet count at presentation failed to show any significant influence on response to first line treatment. However response to splenectomy was found to be higher in patients who had initial complete or partial response with steroids and later relapsed and the platelet count was more than 300x10(9)/L on day 14 of surgery. CONCLUSION: Splenectomy remains the most effective treatment of chronic ITP. No significant factor was identified which predicted initial response to first line treatment. However patients who initially responded to steroids and had platelet counts above 300 X109/L about a fortnight after splenectomy showed promising results post-operatively (p=0.003 and p=0.001).
Authors:
Naveen Naz Syed; Salman Naseem Adil; Raihan Sajid; Mohammad Usman; Bushra Moiz; Ghulam Nabi Kakepoto; Mohammad Khurshid
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  JPMA. The Journal of the Pakistan Medical Association     Volume:  57     ISSN:  0030-9982     ISO Abbreviation:  J Pak Med Assoc     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-04-13     Completed Date:  2007-05-08     Revised Date:  2008-02-12    
Medline Journal Info:
Nlm Unique ID:  7501162     Medline TA:  J Pak Med Assoc     Country:  Pakistan    
Other Details:
Languages:  eng     Pagination:  126-9     Citation Subset:  IM    
Affiliation:
Department of Pathology and Microbiology, Aga Khan University Hospital, Karachi.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Child
Child, Preschool
Female
Follow-Up Studies
Glucocorticoids / therapeutic use*
Humans
Male
Middle Aged
Platelet Count
Prognosis
Prospective Studies
Purpura, Thrombocytopenic / blood,  diagnosis,  therapy*
Recurrence
Risk Factors
Splenectomy / methods*
Treatment Failure
Chemical
Reg. No./Substance:
0/Glucocorticoids

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