[A clinical study of 103 idiopathic thrombocytopenic purpura]

To investigate the prevalence by age, response to different therapies and outcome in newly diagnosed idiopathic thrombocytopenic purpura (ITP).

ITP patients who were hospitalized from July 1992 to December 2006 and followed up with telephone were retrospectively analyzed.

103 patients with ITP were investigated. The time of follow-up was between 2 months to 15years. Male:female = 35:68. The rate of patients over 60 years old was 34.0% (35/103). 59 patients were sensitive to adrenocorticosteroid and 4 patients under going splenectomy achieved a normal platelet count. In those immunosuppressive agents: including vincristine, cyclophosphamide, azathioprine and cyclosporin A(CsA) used in the present series, CsA was shown to be more effective. It could increase the platelet count when given together with prednisolone, the effective rate was 81.3% (26/32). Severe side effects like kiney function failure were not found in CsA treated patients so the use of geug in ITP would be recommended. There were 2, 1 and 1 ITP patients progressing respectively to Sjogren' s syndrome, systemic lupus erythematosus and lymphoma. 7 patients died, 1 patient died of cerebral bleeding, 2 brain infarction, 3 malignant neoplasm and 1 nephrosis The refractory rate of ITP is 17.2% (10/58).

The morbidity in older people is high. The mortal bleeding in ITP is low. Treatment should be tailored to the individual patient.