Prednisone:
1. Consensus Report ITP Blood 2009
International consensus report on the investigation and management of primary immune thrombocytopenia
http://bloodjournal.hematologylibrar...full/115/2/168
Blood, 14 January 2010, Vol. 115, No. 2, pp. 168-186.
Citation:
Corticosteroid therapy. Corticosteroids are the standard initial treatment. Additionally, they may also reduce bleeding, independent of the platelet count rise by means of a direct effect on blood vessels.32,33 Unfortunately their adverse effects rapidly become apparent and create significant complications. With time, the detrimental effects of corticosteroids often outweigh their benefits. Prednisone is the standard initial first-line therapy for ITP patients.22,34,35 Prednisone is usually given at 0.5 to 2 mg/kg/d until the platelet count increases (≥ 30-50 x 109/L), which may require several days to several weeks.9,36,37 Although the treatment is effective, patients are at risk of developing corticosteroid-related complications that vary with the dose and duration. To avoid corticosteroid-related complications, prednisone should be rapidly tapered and usually stopped in responders, and especially in non-responders after 4 weeks.36,38
References:
36 Ben-Yehuda D, Gillis S, Eldor A. Clinical and therapeutic experience in 712 Israeli patients with idiopathic thrombocytopenic purpura. Israeli ITP Study Group. Acta Haematol. 1994;91(1):1–6.[Medline] [Order article via Infotrieve]
38 Pizzuto J, Ambriz R. Therapeutic experience on 934 adults with idiopathic thrombocytopenic purpura: Multicentric Trial of the Cooperative Latin American group on Hemostasis and Thrombosis. Blood. 1984;64(6):1179–1183.[Abstract/Free Full Text]
2. Pizzuto J, Ambriz R. Therapeutic experience on 934 adults with idiopathic thrombocytopenic purpura: Multicentric Trial of the Cooperative Latin American group on Hemostasis and Thrombosis.
http://bloodjournal.hematologylibrar...e2=tf_ipsecsha
Blood. 1984;64(6):1179–1183
Citation: page 5/6 freetext pdf you can download from right above:
Consequently, we recommend corticosteroids
as the initial treatment of choice, particularly
in cases of acute or subacute ITP where the PCR rate
is high. Moreover, the prolonged administration of
corticosteroids is not recommended, because a favorable
response, when it occurs, appears rapidly in one or
two weeks.
3,5
This recommendation is supported by the
data on 477 patients analyzed in this report, which
show that continuation ofcorticosteroids for more than
45 days does not produce an increased incidence of
PCR and only increases the possibility of undesirable
side effects.
2’5’7
References:
2. McMillan R: Chronic idiopathic thrombocytopenic purpura.
N Engl i Med 304:1 135, 1981
3. Karpatkin 5: Autoimmune thrombocytopenic purpura. Blood
56:329, 1980
5. Ambriz R, Conte G, Aviles A, Ortiz A, Sinco A, Morales PM,
Pizzuto i: ıCual es la secuencia terapeutica en Ia purpura trombocitopenica
idiopatica? Analisis en 138 casos. Rev Invest Clin 34:1 13,
1982
7. Gugliotta L, lsacchi G, Guarini A, Ciccone F, Motia MR,
Lattarini C, Lattarino C, Bachetti G, Mazzucconi MG, Baccarani
M, Mandelli F, Tura 5: Chronic idiopathic thrombocytopenic purpura
(ITP): Site ofplatelet sequestration and results of splenectomy.
A study of 197 patients. Scand i Haematol 26:407, 1981
---
Fsn,
Why was MDS not considered as a differentialdiagnosis for ITP? Did you get an initial BMB before diagnosis of ITP?
Asking,
with kind regards,
Margarete