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Comparative study of intravenous high-dose dexamethasone versus intravenous methylprednisolone as an emergent therapy in severe primary immune thrombocytopenia
| Content Provider | Scilit |
|---|---|
| Author | Abuelrus, Hanan M. Saleh, Mostafa F. Mohammed Khedr, Hager M. Mekawy, Adel H. |
| Copyright Year | 2021 |
| Abstract | Background In severe immune thrombocytopenia (ITP), high-dose methylprednisolone (MP) alone or combined with intravenous immunoglobulin showed some efficacy. Reports of use of high-dose dexamethasone (HD-DXM) in this setting are lacking. Objectives To compare between the efficacy and safety of HD-DXM versus MP as an emergency therapy in patients with severe ITP. Patients and methods A total of 50 adult patients with primary severe ITP were divided into two groups (25 in each): HD-DXM was given 40 mg/day intravenous for 4 days, and MP was given 1 g/day intravenous for 3 days. Platelet count was compared on admission and on days 3 and 5 of therapy. After 1 week, response was defined as platelet count more than $30×10^{9}$/l and complete response when platelet more than $100×10^{9}$/l. Results The baseline characteristics of the two groups are well balanced. Mean platelet count on third day showed no significant difference between the two groups (P=0.19). On day 5, HD-DXM group achieved significantly higher platelet count $(90.13±11.41×10^{6}$/ml vs. $65.11±10.38×10^{6}$/ml) than in MP group (P≤0.001). Response and complete response rates after 1 week of therapy were statistically significant higher in HD-DXM group than in MP group (92 vs. 76%; P≤0.001). Hypertension and hyperglycemia were more significant in MP group (28 and 40%, respectively) than in HD-DXM group (8 and 12%, respectively; P=0.01 and 0.01, respectively). Conclusion HD-DXM alone could provide an effective and well-tolerated corticosteroid modality in emergency setting of patients with severe ITP. Prospective randomized trials of HD-DXM alone or in combination with intravenous immunoglobulin for higher efficacy are warranted. |
| Related Links | http://www.ehj.eg.net/article.asp?issn=1110-1067;year=2021;volume=46;issue=1;spage=58;epage=63;aulast=Khedr;type=2 |
| File Format | XHTML |
| ISSN | 11101067 |
| DOI | 10.4103/ejh.ejh_33_20 |
| Journal | The Egyptian Journal of Haematology |
| Issue Number | 1 |
| Volume Number | 46 |
| Language | English |
| Publisher | Medknow |
| Access Restriction | Open |
| Subject Keyword | Medical Laboratory Technology Comparative Study Dexamethasone Emergent Therapy Immune Thrombocytopenia Methylprednisolone The Egyptian Journal of Haematology, Volume 46, Issue 1 |
| Content Type | Text |
| Resource Type | Article |
