Clinical Effect of the Combination Therapy with High Dose Gammaglobulin and Prednisolone on Chronic Idiopathic Thrombocytopenic Purpura in Children

Abstract

Corticosteroid has been widely given to patients of chronic idiopathic thrombocytopenic purpura (ITP), but its effect has not been thought to be always beneficial. Furthermore methylprednisolone pulse, immunosuppressive agents or high dose gammaglobulin treatment has not always brought a satisfactory result.
Then, we tried a combination therapy of glucocorticoid and high dose gammaglobulin to three non-splenectomised patients. Two of them were resistant to glucocorticoid and high dose gammaglobulin therapy alone and the third showed only a transient response to each thrapy. In the former two, the prominent increase in platelet count were seen and in the latter, the suitable effect lasted longer than glucocorticoid and high dosegammaglobulin therapy alone.
Therefore, this combination therapy might be recommended to chronic ITP patients who are resistant to glucocorticoid or high dose gammaglobulin therapy respectively or show only transient effect to each one.