Recurrence rate in patients with acute immune thrombocytopenic purpura in Ahvaz, southwest of Iran: Corticosteroids versus intravenous immunoglobulin

A. Safapour, Arash Alghasi, F. Abolnezhadian
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Abstract

Introduction: Immune thrombocytopenic purpura (ITP) is known as the most important cause of sudden drop in platelet count among children. The acute form of unexpected drop in platelet count in children calls for treatment with medications such as corticosteroids, intravenous immunoglobulin (IVIg), and Rho(D) immunoglobulin (anti-DIG). Most of the previous studies have accordingly compared short-term therapeutic outcomes of steroids with those of IVIg. In some cases, IVIg has led to better results. However, there are few studies on the long-term treatment effects of both medicine categories. Objectives: This study was aimed to evaluate the therapeutic effects and recurrence rate (RR) of corticosteroids, IVIg, or both in the long-term to find the best and most effective treatment for these patients. Patients and Methods: A total of 188 children diagnosed with acute ITP were admitted to the hematology departments of Shafa and Baghaei hospitals of Ahvaz, Khuzestan, Iran. The therapeutic consequences and RRs of corticosteroids, IVIg, or both were compared within one year. Results: Comparing treatments employing corticosteroids and IVIg in children having acute ITP in terms of the long-term treatment outcomes showed no statistically significant difference. In addition, the findings revealed that 34% of the patients had experienced recurrence within one year with no remarkable difference between both drug groups. Conclusion: The long-term therapeutic outcomes in both medicine categories were not significantly different. Therefore, given the world’s current economic conditions and inadequate supply of all medicines, it seems more rational to use the least expensive drugs.
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伊朗西南部阿瓦士地区急性免疫性血小板减少性紫癜患者的复发率:皮质类固醇与静脉注射免疫球蛋白
导论:免疫性血小板减少性紫癜(ITP)被认为是儿童血小板计数突然下降的最重要原因。急性形式的血小板计数意外下降的儿童需要治疗药物,如皮质类固醇,静脉注射免疫球蛋白(IVIg)和Rho(D)免疫球蛋白(抗dig)。大多数先前的研究相应地比较了类固醇与IVIg的短期治疗结果。在某些情况下,IVIg带来了更好的结果。然而,关于这两类药物的长期治疗效果的研究很少。目的:本研究旨在评估皮质类固醇、IVIg或两者的长期治疗效果和复发率(RR),为这些患者寻找最佳和最有效的治疗方法。患者和方法:共有188名诊断为急性ITP的儿童在伊朗胡齐斯坦省阿瓦士的Shafa和Baghaei医院血液科就诊。在一年内比较皮质类固醇、IVIg或两者的治疗效果和rr。结果:急性ITP患儿采用皮质类固醇治疗与IVIg治疗远期疗效比较,差异无统计学意义。此外,研究结果显示,34%的患者在一年内复发,两组之间无显著差异。结论:两类药物的远期疗效无显著性差异。因此,鉴于世界目前的经济状况和所有药物供应不足,使用最便宜的药物似乎更为合理。
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