PMID- 14768792
OWN - NLM
STAT- MEDLINE
DCOM- 20040224
LR  - 20131121
IS  - 0041-4301 (Print)
IS  - 0041-4301 (Linking)
VI  - 45
IP  - 4
DP  - 2003 Oct-Dec
TI  - A randomized and comparative study of intravenous immunoglobulin and mega dose 
      methylprednisolone treatments in children with acute idiopathic thrombocytopenic 
      purpura.
PG  - 295-300
AB  - The most common cause of mortality in childhood acute idiopathic thrombocytopenic 
      purpura (ITP) is intracranial hemorrhage (ICH), which occurs in about 0.1% of 
      children with platelet counts below 20,000/microl. Forty-two children (1-13 
      years) with ITP and platelet counts < or = 20,000/microl were randomly divided 
      into two groups. Twenty patients received mega-dose methylprednisolone (MDMP) in 
      a dosage of 30 mg/kg/d for three days and 20 mg/kg/d for four days. Twenty-two 
      patients received intravenous immunoglobulin (IVIG) in a dosage of 1 g/kg/d two 
      days. Platelet counts of the patients were determined at diagnosis, at 2, 4, 7, 
      14, 30, 60, 90, 120, 150, and 180 days and at three-month intervals after the 6th 
      month. The mean platelet counts of both groups gradually increased and peaked on 
      the 7th day (p > 0.05). There were no significant differences between the mean 
      platelet counts of patients, in the two groups on treatment days 0, 2, 4, 7, and 
      14. The mean time for achievement of platelet counts above 20,000/microg in the 
      MDMP group and the IVIG group was 4.1 and 2.9 days (p < 0.05) and above 
      50,000/microl was 5.0 and 5.2 days (p > 0.05), respectively. The percentages of 
      patients with platelet counts above 20,000/microl at the 2nd day of the treatment 
      were 50% in the MDMP group, and 86% in the IVIG group (p < 0.05). No significant 
      differences were observed in the mean platelet counts of the two groups treatment 
      days 30, 60, 90, 120 and 180 (p > 0.05). Chronic ITP developed in five patients 
      (25%) in the MDMP group, and in four patients (18%) in the IVIG group (p > 0.05). 
      Intravenous immunoglobulin (IVIG) (1 g/kg/d for 2 days) and MDMP treatments (30 
      mg/kg/d for 3 days, 20 mg/kg/d for 4 days, perorally) are equally effective in 
      the treatment of acute ITP. Because of its nonbiologic source, lower cost, fewer 
      side effects and oral use, we prefer oral preparations of MDMP in the treatment 
      of childhood ITP.
FAU - Erduran, Erol
AU  - Erduran E
AD  - Department of Pediatrics, Karadeniz Technical University, Faculty of Medicine, 
      Trabzon, Turkey.
FAU - Aslan, Yakup
AU  - Aslan Y
FAU - Gedik, Yusuf
AU  - Gedik Y
FAU - Orhan, Fazil
AU  - Orhan F
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - Turkey
TA  - Turk J Pediatr
JT  - The Turkish journal of pediatrics
JID - 0417505
RN  - 0 (Glucocorticoids)
RN  - 0 (Immunoglobulins, Intravenous)
RN  - X4W7ZR7023 (Methylprednisolone)
SB  - IM
CIN - Turk J Pediatr. 2004 Jul-Sep;46(3):292; author reply 293. PMID: 15503490
MH  - Acute Disease
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Dose-Response Relationship, Drug
MH  - Drug Administration Schedule
MH  - Glucocorticoids/administration & dosage/adverse effects/*therapeutic use
MH  - Humans
MH  - Immunoglobulins, Intravenous/*therapeutic use
MH  - Infant
MH  - Methylprednisolone/administration & dosage/adverse effects/*therapeutic use
MH  - Platelet Count
MH  - Purpura, Thrombocytopenic, Idiopathic/*drug therapy
EDAT- 2004/02/11 05:00
MHDA- 2004/02/26 05:00
CRDT- 2004/02/11 05:00
PHST- 2004/02/11 05:00 [pubmed]
PHST- 2004/02/26 05:00 [medline]
PHST- 2004/02/11 05:00 [entrez]
PST - ppublish
SO  - Turk J Pediatr. 2003 Oct-Dec;45(4):295-300.