Side effects of corticosteroid therapy in children with chronic idiopathic thrombocytopenic purpura

Abstract

In 29 symptomatic children of both sexes with chronic idiopathic thrombocytopenic purpura (CITP) with platelet counts ≤30,000/mm³, of mean age 7.2 ± 1.3 years, the side effects of long-term glucocorticoid therapy were evaluated. Patients were divided into three groups based on the different glucocorticoid protocols they were receiving. Baseline measurements (t⁰) of height (H) as standard deviation score (SDS), body mass index (BMI) as kg/m² and bone mineral density (BMD) at the femoral neck (FBMD) and lumbar spine L ₂–L ₄ (LBMD) by a dual energy X-ray absorption technique, expressed as Z score, with follow-up measurements at 1 (t¹) and 2 (t²) years were assessed. Group I patients (10 pts) treated with oral prednisone (2 mg/kg/die-for one month for 2 cycles) showed significantly different HSDS, BMI, FBMD and LBMD at t¹ and t² (P < 0.005) than other groups treated respectively with pulsed high doses of dexamethasone (24 mg/m² over 4 days/months for 6 cycles) and methylprednisolone (9 mg/kg/die for 5 days for 3–4 months). These findings suggest that pulsed high doses of glucocorticoid lead to fewer side effects than oral prednisone therapy.

Keywords:

• CORTICOSTEROID
• CITP
• HSDS
• BMI
• FBMD
• LBMD