Evaluation of treatment modalities of acute idiopathic throm- bocytopenic purpura in Al-zahraa teaching hospital in Al-Najaf

Abstract

Background: Acute idiopathic thrombocytopenic purpura(I.T.P) is a bleeding disorder in which the immune system for unknown reason produce antibodies against platelets, which are necessary for normal blood clotting resulting in decrease number of circulating platelets, manifested itself by bleeding tendency, easy brusing or extravasation of blood from capillaries in the skin and mucous membrane .
Objective: to choose the most appropriate therapy for acute idiopathic thrombocytopenic purpura management .
Methods : 65 patients were enrolled in this retrospective study, who were admitted to AL-Zahraa teaching hospital from January 2000 to January 2010 . Relevant information were collected according to preceding data collection sheet that include age, sex, initial hemoglobin and platelets count, treatment given, response to therapy…These patients subdivided into 3 groups according to initial drug used for their management either prednisolone, I.V.immunoglobulin-G, or anti-D. The response was analyzed according to rapid rise of platelets number in the pre-treatment state. chronic cases of I.T.P were excluded from this study .
Results: All patients were aged from 2-12 years with peaks of 2-5 years. Sex ratio (female\male) of 1:1.7 .Our study showed that out of 65 patients, 37(57%) of them were assigned as group 1 who received prednisolone as a conventional therapy ,the response was noted in 31( 86.5%) after few days of treatment. Regarding group 2 patients received I.V immunoglobulin-G, the response of platelets rise was noted in 16( 89%) of cases out of 18 patients . While(10) patients in group 3 who received anti-D as main line of treatment to Rh-positive individuals, the response is observed in only 6( 60%) of cases .
Conclusion: Regarding various treatment modalities of idiopathic thrombocytopenic purpura ,it has been noted that oral prednisolone is the best, single, readily available, inexpensive drug that can be taken orally and as outpatient .
Recommendation:The availability of other treatment options such as I.V-immunoglobulin-G should be adopted in our hospitals in cases of life- threatening illness as it induces more rapid rise in platelets in comparison with other drugs.