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[Glucocorticoids therapy as a first line treatment in ITP]

Kingo Fujimura1

  • 1Department of Hemato Oncology, Division of Pharmacotherapeutics, Hiroshima University Graduate School of Biomedical Sciences.

Nihon Rinsho. Japanese Journal of Clinical Medicine
|April 30, 2003
PubMed

Idiopathic thrombocytopenic purpura(ITP) is an immunohematological disorder for which appropriate diagnostic and treatment strategies are unclear. In 1982 in Japan and 1996 in ASH, guideline for ITP treatment was produced, respectively. These guidelines selected the steroid for the first line treatment. Appropriate steroid treatment was recommended based on the severity or grade of bleeding and platelet counts. Patients with platelet counts above 50,000 do not require treatment ordinarily. Treatment was indicated in-patients with platelet counts under 20,000-30,000, and those with platelet counts under 50,000 with presence of bleeding tendency or risk factor for bleeding. Most ITP patients responded well with initial steroid treatment and 33% of them had a complete remission from ITP, but remaining patients decreased platelet counts with the steroid dose reduction. The management of the bleeding symptoms without the adverse effects is an important point of steroid medication in ITP after first line treatment.

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