The retrospective evaluation of patients diagnosed with acute immune thrombocytopenic purpura and comparison of treatments of high-dose methylprednisolone and intravenous immunoglobulin

Objective: One of the most common causes for acquired thrombocytopenia in childhood is immune thrombocytopenic purpura (ITP) which is an autoimmune disease characterized by decreased platelet counts and inhibition of platelet production due to antibody-mediated destruction of platelets by macrophages in the reticulo endothelial system. In this study, we aimed to compare high-dose methylprednisolone (HDMP) and intravenous immunoglobulin (IVIG) in the treatment ITP. Materials and Methods: The medical records of 160 patients who were admitted to our Pediatric Hematology Department with the diagnosis of acute ITP between January 2010 and August 2014 were retrospectively analyzed. Treatment responses to HDMP and IVIG were compared. Results: Of the patients, 91 (56.9%) were males. A total of 48.13% of them had a previous history of infection for one to four weeks before admission. The mean platelet count was 12.081±11.912 /mm3. A total of 105 patients received HDMP, while 55 patients received IVIG. There was no statistically significant difference in the treatment response to HDMP or IVIG on the 10th day of the treatment (p=0.732). At the end of six months, there was no significant difference between the patients receiving HDMP and IVDG in terms of progression to chronicity (p=0.468). The rate of chronicity and relapses was found to be statistically significantly higher in 15% of the patients with a bleeding time of more than 7 minute at the time of arrival (p=0.031). Conclusion: Based on our study results, we suggest that HDMP and IVIG treatments have similar effects on disease progression to chronicity