Idiopathic Thrombocytopenic Purpura

Long-term response to corticosteroid therapy and splenectomy was evaluated in 66 adults with idiopathic thrombocytopenic purpura (ITP). In 75% of 57 patients, a rise in platelet count was observed during administration of corticosteroids. In 49% of the 57, platelet counts of greater than 50,000/cu mm were documented four months after cessation of treatment, and in 37% a sustained remission throughout follow-up periods of 1 to 18 years was seen. Splenectomy produced good or excellent responses in 83% of 35 patients evaluated four months after operation and in all but two patients remission has been sustained during follow-up periods of 1 to 25 years. Prognosis based upon response to the initial course of corticosteroid treatment appears to be more reliable than that based upon duration of symptoms prior to treatment.