Document Detail

Splenectomy for immune thrombocytopenic purpura.
MedLine Citation:
PMID:  7235958     Owner:  NLM     Status:  MEDLINE    
Of 481 splenectomies performed at the University of Utah, Salt Lake City, 78 (16.2%) were for immune (idiopathic) thrombocytopenic purpura (ITP). The mean platelet count prior to therapy was 13,800/cu mm (range, 500 to 80,000/cu mm). All but two patients were initially treated with corticosteroids, and 58.2% responded with an increase in platelets (mean, 77,900/cu mm). The indications for splenectomy included (1) failure to respond to steroids (33.8%); (2) inability to taper steroids (52.1%); (3) recurrent ITP (5.6%); and (4) miscellaneous (8.5%). There was one death following splenectomy, and the postoperative morbidity was 14.1%. Complete remission occurred in 77.3%, and 84.8% were judged to have benefited from the procedure. The remission rate following splenectomy in patients who responded to preoperative steroids was 93.2%, whereas improvement fell to 68.3% in patients who failed to respond to steroids. This study confirms the benefit of splenectomy for ITP and demonstrates a predictive correlation with response to preoperative preparation with corticosteroids in these patients.
S J Mintz; S R Petersen; B Cheson; L J Cordell; R C Richards
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  116     ISSN:  0004-0010     ISO Abbreviation:  Arch Surg     Publication Date:  1981 May 
Date Detail:
Created Date:  1981-07-20     Completed Date:  1981-07-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  645-50     Citation Subset:  AIM; IM    
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MeSH Terms
Adrenal Cortex Hormones / therapeutic use
Child, Preschool
Middle Aged
Platelet Count
Thrombocytopenia / diagnosis,  drug therapy,  surgery*
Reg. No./Substance:
0/Adrenal Cortex Hormones

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