a survey of 121 patients with idiopathic thrombocytopenic purpura

introduction: idiopathic thrombocytopenic purpura is one of the most common causes of thrombocy-topenia with varius clinical courses and different responses to its treatment modalities. therefore, we decided to evaluate the clinical course of this disease in our patients.
methods: in this case series study, from march 1998 to march 2004, we evaluated 121 patients. as a first line of treatment, all of those patients received prednisolone (1mg/kg/day) for 6 weeks. those who didn't respond or were refractory to prednisolone were candidates for splenectomy, and those who re fused these modalities or didn't respond to them were treated with azathioprine.
results: 99 patients (81.8%) were female and 22 (18.2%) were male, aged 11-73 years (mean; 28.6). two patients had immune hemolytic anemia in addition to thrombocytopenia, 4 had systemic lupus erythematosus, and one was hiv positive. %44.6 of patients fully responded to prednisolone, 42 pa tients (%34.7) underwent splenectomy and %83.3 of them responsed to it.31 splenectomies were per formed in the first three months after diagnosis and 27 (87.1%) of them showed complete response, but 8 (72.7%) of the patients splenectomized after 3 months, had complete response. 14 patients were treated with azathoprine, 2 of which (14.3%) platelet count normalized.
conclusion: itp is more common in females than males. prednisolone is preferred as a non-invasive treatment with suitable response in comparison to other modalition responses to splenectomy, indicat ing that this modality of treatment is useful and effective, especially when performaed in the first 3 months of the diseases.