HIGH DOSE PULSE DEXAMETHASONE THERAPY IN CHRONIC IDIOPATHIC THROMBOCYTOPENIC PURPURA.

We studied the response to pulse high dose dexamethasone (DXM) in 12 consecutive patients of symptomatic chronic idiopathic thrombocytopenic purpura (ITP) who had not responded to the standard forms of therapy. All patients had been exhibited to two or more cycles of prednisolone. Besides this 5 patients had also been given danazol and 4 patients had undergone splenectomy. Six cycles of dexamethasone (40 mg per day for 4 sequential days every 4 weeks) were successfully given in all 12 patients. At the end of the sixth cycle there were 7 (58%) complete responders (CR) [platelet count (PLT)100 × 109 /L], 1 partial responder (PR) [PLT-50-100 × 109/L] and 4 non responders (NR) [PLT < 50 × 107L]. Follow up at 1 year showed 4 (33.3%) patients each in CR, PR and NR group. Side effects noted were increased appetite in 8 (66.6%) patients, hyperalertness in 6 (50%) patients, abdominal discomfort in 5 (41.6%) patients and nausea with vomiting in 2 (16.6%) patients. We were not able to identify any chemical or laboratory prognostic parameter which would allow prediction of a successful outcome of this treatment.