Platelet Levels of High- and Mega-Dose Methylprednisolone Treatment in Acute Immune Thrombocytopenia

摘要

High-dose methylprednisolone (HDMP) therapy wasoriginally used by Ozsoylu et al. in the treatment of immunethrombocytopenic purpura (ITP), and it is also important inthe history of Turkish hematology [1,2].A 16-year-old male (weight: 107.5 kg, height: 167 cm,BMI: 38.5 kg/m2) presented with the complaints of oralsubmucosal bleeding and purpura. Complete blood countanalysis revealed a platelet count of 1900/mm3, and hisperipheral blood smear and bone marrow aspiration slideswere consistent with ITP. Informed consent was obtained forHDMP and MDMP treatment.High-dose methylprednisolone was initiated at a dose of1000 mg/day for 3 days followed by 750 mg/day for 4 days,with each dose administered orally early in the morning.Platelet count reached 28,000/mm3 and 31,000/mm3 onthe 3rd and 7th days of treatment, respectively. Mucosal andcutaneous bleeding ceased. Methylprednisolone treatmentwas continued at a dose of 1 mg/kg/day for 7 days andtapered over a week. Platelet count was 22,000/mm3 on thelast day, but bleeding reoccurred 10 days later and plateletcount was 3900/mm3.