HIGH-DOSE METHYLPREDNISOLONE IS AN ALTERNATIVE TREATMENT FOR ADULTS WITH AUTOIMMUNE THROMBOCYTOPENIC PURPURA REFRACTORY TO INTRAVENOUS IMMUNOGLOBULINS AND ORAL CORTICOSTEROIDS

Eight patients with severe chronic autoimmune thrombocytopenic purpura (AITP) refractory to high-dose intravenous immunoglobulin (IVIgG) and/or oral prednisone were treated with one to three infusions of high-dose methylprednisolone (HDMP) (15 mg/kg/day). The mean platelet count before treatment was 12 +/- 10 x 10(9)/L. HDMP therapy led to a safe platelet count (>50 x 10(9)/L) after 2-5 days in five patients, and a minimal platelet increase (34 x 10(9)/L) able to stop bleeding in a sixth patient. The effect of HDMP was, however, transient in four of the five responders. No side effects were observed, even in the four patients older than 70 years. HDMP thus appears to be a good alternative in emergency situations or prior to surgery for patients with AITP refractory to conventional therapy. (C) 1995 Wiley-Liss, Inc.