Annals of Hematology

, Volume 83, Issue 12, pp 764–768

High-dose dexamethasone as a first- and second-line treatment of idiopathic thrombocytopenic purpura in adults

  • F. Borst
  • J. J. Keuning
  • H. van Hulsteijn
  • H. Sinnige
  • G. Vreugdenhil
Original Article


The current first-line choice of treatment of idiopathic thrombocytopenic purpura (ITP) in adults, prednisone, is effective but has many side effects. Furthermore, reduction of the dose leads to a relapse of ITP in a majority of cases. Courses of high-dose dexamethasone (HD) aim to avoid these problems. We treated 36 patients with newly diagnosed or recurrent ITP with an 8-day course of HD, with a peak dose of 40 mg/day. The courses were repeated up to a maximum of six courses, with a 28-day interval. Acute and chronic effects of HD on platelet counts were observed, as well as side effects. HD led to an acute response (rise of platelet count to a level above 50×109/l) in 83%. When HD was given as a first-line treatment, 59% of patients were still in remission after 31 months. When HD was given as a second-line treatment, 50% of patients were in remission after 5 months, declining to 25% after 54 months. Side effects were frequent but rarely dangerous. In conclusion, acute effects of HD were excellent. Long-term effects of HD as a first-line therapy of ITP were good, but its long-term effects as a second-line therapy were much poorer.


Dexamethasone Idiopathic thrombocytopenic purpura 


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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • F. Borst
    • 1
  • J. J. Keuning
    • 2
  • H. van Hulsteijn
    • 3
  • H. Sinnige
    • 4
  • G. Vreugdenhil
    • 2
  1. 1.Department of NephrologyUniversity Medical Centre St RadboudNijmegenThe Netherlands
  2. 2.Department. of Internal MedicineMaxima Medical CentreVeldhovenThe Netherlands
  3. 3.Bernhoven HospitalVeghelThe Netherlands
  4. 4.Jeroen Bosch Hospital‘s HertogenboschThe Netherlands

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