Steroid responsiveness. A predictor of the outcome of splenectomy in children with chronic immune thrombocytopenic purpura.

Splenectomy is curative for many children with chronic immune thrombocytopenic purpura (ITP), but not without placing them at increased risk for serious infections. To determine the reliability of a trial of corticosteroids in predicting the outcome of splenectomy, 36 children with chronic ITP were studied retrospectively. All 20 of the children with a good response to corticosteroids achieved a complete remission after splenectomy, whereas only two of 13 nonresponders exhibited a lasting benefit from surgery. Corticosteroid responsiveness was found to be a highly reliable method of correctly identifying those patients with chronic ITP who would benefit from splenectomy.