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High dose dexamethasone as an alternative rescue therapy for active bleeding in children with chronic ITP: clinical and immunological effects.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Youssef, Mervat A. M. Eldeen, Eman Salah Elsayh, Khalid I. Taha, Samaher F. Aboelela, Mohamed Adel |
| Copyright Year | 2018 |
| Abstract | High-dose dexamethasone (HD-DXM) is debated as a second-line therapy for chronic Immune thrombocytopenia (ITP) in children. The aim of this study is to evaluate the efficacy and safety of HD-DXM as an emergency therapy in uncontrolled bleeding in children with chronic ITP and to assess its immunological effect on dendritic cells (DCs) percentage and their co-stimulatory markers CD86 and CD83. Totally, 20 children previously diagnosed as chronic ITP were enrolled in this study and all admitted to hospital with uncontrolled bleeding. Patients received HD-DXM as a single daily dose for 4 days. Blood samples were withdrawn from patients just prior to HD-DXM therapy and on day 5 to evaluate the platelet count and for flowcytometric analysis of DCs. Daily assessment of bleeding severity was performed. The platelet counts significantly increased in patients after 5 days of initiation of therapy compared with platelet count before therapy (p-value = 0. 0002). Control of bleeding observed in (90%), complete response (CR) documented in (50%), response (R) documented in (40%), and no response (NR) documented in (10%) of patients. The time to respond was raging from 1 to 3 days and minor complication recorded in two patients. Both plasmacytoid DCs and myeloid DCs percentage and their expression of co-stimulatory markers, CD86 and CD83 decreased significantly after HD-DXM therapy. Conclusion: short course of HD-DXM as a rescue therapy seems to be an effective alternative emergency treatment for uncontrolled bleeding in chronic ITP children especially in nations with limited resources. |
| Starting Page | 1 |
| Ending Page | 7 |
| Page Count | 7 |
| File Format | PDF HTM / HTML |
| DOI | 10.1080/09537104.2018.1530347 |
| Alternate Webpage(s) | http://www.aun.edu.eg/reserches_files/31662.pdf |
| PubMed reference number | 30346851 |
| Alternate Webpage(s) | https://doi.org/10.1080/09537104.2018.1530347 |
| Journal | Medline |
| Journal | Platelets |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
