Abstract
We encountered a hemodialysis patient complicated by idiopathic thrombocytopenic purpura (ITP). A 60-year-old man had been on hemodialysis due to diabetic nephropathy until May 1999. We administered alprostadil from November 2002 when arteriosclerosis obliterans worsened. Thrombocytes decreased to 0.6×104/μL on February 2003. Although alprostadil and other drugs were discontinued thrombocytopenia did not abate and bone marrow assessment showed ITP. He started oral steroid therapy for ITP but there was no response. Thereafter, developed a he perianal abscess. Secondly, oral danazol was initiated and three days later, thrombocytes rose to 2.6×104/μL. Low-dose danazol was very effective and did not cause any harmful aftereffects. There have not been any recurrences while the patient continued on tapered doses of danazol for 15 months or after discontinuation of danazol for 33 months. Therefore, we concluded low dose danazol was an optional rescue procedure for treating ITP developing in a patient on maintenance hemodialysis.
