Immunosuppressive agents in the treatment of chronic idiopathic thrombocytopenic purpura'

  • A. H. Markum Department of Child Health, University of Indonesia Medical School, Jakarta
  • Maria Abdulsalam Department of Child Health, University of Indonesia Medical School, Jakarta
  • S. Muslichan Department of Child Health, University of Indonesia Medical School, Jakarta
  • Iskandar W. Department of Child Health, University of Indonesia Medical School, Jakarta
Keywords: immunosuppressive agents, chronic idiopathic thrombocytopenic purpura, ITP, corticosteroid

Abstract

Acute idiopathic thrombocytopenic purpura (I. T.P.) in childhood is a
condition with a self-limiting course that will usually improve spontaneously. In severe cases, however, blood transfusion and corticosteroids are indicated. Lusher and Zuelzer (1966) who analysed 152 cases of acute I.T.P. in children concluded that 92.6% of the untreated as well as 97.5% of the corticosteroid-treated gave uneventful recovery without recurrence of thrombocytopenia. On the other hand, in chronic I.T.P., where the immune mechanisms play
a more important role than in acute I.T.P., administration of corticosteroids seems of little value. Harrington et al. (1951) found the presence of platelet antibodies in 8 out of 10 cases of chronic I.T.P. The importance of platelet antibodies which either destroy or inhibit platelet formation from megakaryocytes in the bone marrow; has been demonstrated by other investigators (Kuramoto, 1966; Rolovic et aI., 1970). 

References

1. BALDINI, M. : Idiopathic thrombocytopenic purpura. New Engl. J. Med. 274 : 1245. 1301, 1360 (1966).
2. BENHAM, E.S. and TAFT, L.I.: Idiopathic thrombocytopentc purpura in children: results of steroid therapy and splenectomy. Austr. paediat. J. 8: 311 (1972).
3. BOURONCLE. B.A and DOAN, C.A.: Treatment of refractory idiopathic thrombocytopenia. J. amer. med. Ass. 207: 2049 (1969).
4. BROOKS, P. L.: O'SHEA, M.J .and PRYOR, J.P. : Splenectomy in the treatment of idiopathic thrombocytopenic purpura. Brit. J. Surg. 56: 861 (1969).
5. D'AMARO, J.; LEEUWEN, A. van; SVEJGAARD, A. and ROOD, J.J. van: The micro-complement fixation test. U. Serologic and comparative studies. Histocompatibility testing, p. 539 (Munksgaard, Copenhagen 1970).
6. DAUSSET, J.: Technique de rechereer d'une thromboagglutinine chaude par Ie test au phenol. Selon MAJSKY et KRECKOV A; Z. Immun. Forsch. 130 : 279 (1966).
7. HARRINGTON, W.J.; HOLLINGSWORTH, J.W.; MINNICH, Y. and
MOORE, C,V.: Demonstration of thrombocytopenic factor in the blood on patients with idiopathic thrombocytopenic purpura. J. Clin. Invest. 30 : 646 (1951).
8. KURAM9TO, A. : Mechanism of thrombocytopenia in idiopathic thrombocytopenic purpura (I.T.P.). IV. Evaluation of fluorescent antibody method and specific staining of platelets and megakaryocytes of I.T.P. Acta haemat. jap. 29 : 819 (1966).
Abstract from Blood 30: 820 (1967).
9 . LO, S.A;HITZIG, W.H. and SIGG, P.: Management of chronic idiopathic thrombocytopenic purpura in children with particular reference to immunosuppressive therapy. Acta haemat.41:
1 (1969).
10. LUSHER, J.M. and ZUELZER, W.W.: Idiopathic thrombocytopenic purpura In childhood, J. Pcdiat. 68 : 971 (1966).
11. PIZZI, F.; CARRARA, P.M.; ALDECHI, A. and ERIDANI, S. : Immunofluorescence of megakaryocytes in the 1hrombocytopenic pm-puras. Blood 27: 521 (1966).
12. REIQUAM, C.W. and PROSPER, J.C.: Chronic idiopathic thrombocytopenia; treatment with prednisone, 6-mercaptopurine, vincristine and fresh plasma transfusion. J. Pediat. 68 : 885 (1966).
13. ROBERTSON, J.H. : Uracil mustard In the treatment or thrombocytopenia. Blood 35: 288 (1970).
11. ROLOVIC, Z.; BALDINI, M. ood DAMESHEK, W.: Megakaryocytopoiesis in experimentally induced immune
thrombocytopenia. BUod 35 : 173 (1970).
15. SALZSTEIN, S.L : Phospholipid in histiocytes of splenic pulp
associated with thrombocytopenic purpura. Blood 18: 73 (1961).
16. STORTI, E.; FONTANA, G. and PERUGINI. S. : Busulphan (1. 4-dimethansulphonoxybutane) in the therapy of polycythemia and hemorrhagic thrombocythemia. Progr. Med. (Napoli) 22 : 510 (1966). Abstract from Blood 30 : 256 (1967).
Published
1973-03-30
How to Cite
1.
Markum A, Abdulsalam M, Muslichan S, W. I. Immunosuppressive agents in the treatment of chronic idiopathic thrombocytopenic purpura’. PI [Internet]. 30Mar.1973 [cited 20Apr.2024];13(3):77-2. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/1326
Section
Articles
Received 2017-03-23
Published 1973-03-30