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September 1973

Chronic Idiopathic Thrombocytopenic Purpura: Treatment With Steroids and Splenectomy

Author Affiliations


From the Department of Medicine, Division of Hematology, University of Maryland, School of Medicine, Baltimore.

Arch Intern Med. 1973;132(3):380-383. doi:10.1001/archinte.1973.03650090062011

Ninety-two patients, followed up from 1 to more than 20 years, fulfilled our diagnostic criteria of chronic idiopathic thrombocytopenic purpura. Of the 91 patients treated with steroids, there was eventual complete remission in 26 (28.5%). Splenectomy was performed in 51 patients, all except one of whom had failed to respond satisfactorily to steroids. Ten of the 44 who had good responses to splenectomy had relapses after one half to 20 years. At this time 36 of the 51 splenectomized patients (70%) are in good remission.

In this series, four definite cases of systemic lupus erythematosus appeared. All had had splenectomy from one to four years earlier with good responses. Two splenectomized patients died with infections. One had cytomegalovirus pneumonia associated with relapse of idiopathic thrombocytopenic purpura and immunosuppressive therapy. The other had systemic lupus erythematosus and pneumococcal meningitis.

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