The Use of Azathioprine in Refractory Idiopathic Thrombocytopenic Purpura in Children

Summary Five children with refractory ITP were treated with azathioprine for 8‐27 months. An excellent response was obtained in 3 of the 5 patients, a good response in a fourth. In two presplenectomy cases the result was obtained using azathioprine alone and two post‐splenectomy cases required low dose steroids in addition to azathioprine. One pre‐splenectomy patient failed to respond to the drug alone or in combination with steroids but responded well to splenectomy. A review of the cases in the literature and the experience presented here suggests that azathioprine has a definite role in the therapy of refractory idiopathic thrombocytopenic purpura in childhood.