[Cost-conscious procedure in treatment of autoimmune thrombocytopenic purpura]

Autoimmune thrombocytopenic purpura is a common hematologic autoimmune disease. Approximately three fourth of the patients respond to corticosteroids or splenectomy and need no further treatment. Patients refractory to these two therapeutic approaches are relatively resistant to other forms of treatment and are at much greater risk for morbidity and mortality. The therapeutic choice for the refractory patient depends on the age of the patient, the degree of thrombocytopenia, on compliance, toxicity, costs of the treatment and expected duration of the response. Since there is no universal option for all patients, physicians and patients must be prepared to try several approaches over a long period of time.