Treatment of Chronic Idiopathic Thrombocytopenic Purpura in the Adult

Abstract

Splenectomy is the treatment of choice in the great majority of cases of chronic idiopathic thrombocytopenic purpura. The cure rate with corticosteroid therapy is very low in contrast to the 70 to 80 per cent figure with splenectomy. Dangers of long-term use of corticosteroids include the chance of actual platelet reduction. While chronic ITP occasionally is the initial and only manifestation of systemic lupus erythematosus, the authors are convinced that splenectomy does not lead to immediate spread of lupus in these cases, and that lasting cure of chronic ITP is possible. Moreover, the occurrence of lupus erythematosus in chronic ITP is unusual, not of the magnitude some authors suggest.