Abstract
Five children with refractory chronic idiopathic thrombocytopenic purpura (ITP) were treated with danazol and the clinical effectiveness of the drug was evaluated. Patients comprised 2 boys and 3 girls, whose age ranged from 6 to 14 years. Their platelet counts continued to be less than 50, 000/μl over 6 months after onset of the disease, and no improvement was observed in spite of various therapies. Danazol was given at the doses of 200-600 mg daily for 2 to 6 months. Four of the five patients exhibited increases in platelet counts to more than 50, 000/μl within 2 weeks after administration of the drug : three of these patients (2 boys, 1 girl) showed sustained levels of more than 100, 000/μl over 2 months, suggesting that the effective rate of danazol therapy is 60%. Two patients showed side effects : one with slight acne on the face, and the other with transient mild menorrhagia, but no abnormal liver function was noted. The effect of danazol on the recovery of platelet counts in ITP patients seems to be attributed to inhibition of platelet antibody production ; this was deduced from the fact that the high level of platelet-associated IgG on pretreatment stage in 3 effectively treated patients declined to the normal range during or on completion of treatment. In conclusion, danazol therapy is thought to be an effective and safe treatment for children with refractory chronic ITP.
