Idiopathic thrombocytopenic purpura in elderly patients: A study of 47 cases from a single reference center

Samira Daou, Laure Federici, Jacques Zimmer, Frédéric Maloisel, Khalid Serraj, Emmanuel Andrès*

*Corresponding author for this work

    Research output: Contribution to journalArticleResearchpeer-review

    31 Citations (Scopus)


    Background: Idiopathic thrombocytopenic purpura (ITP) is often diagnosed in the elderly, but no specific guidelines exist for such patients. We describe our experience with ITP management in elderly patients and analyze the therapeutic response. Methods: We retrospectively reviewed a cohort of 47 consecutive elderly ITP patients (≥ 60 years old) followed in a single reference center. We specifically analyzed the clinical characteristics, therapies used, patient response rates, and side effects. Results: The mean age of the 47 patients was 66 (range 60-82) years; 31 patients were female. Their initial presentation included bleeding limited to the skin (n = 10, 21%) and bleeding at one or more other sites (n = 26, 56%); 11 patients (23%) were asymptomatic. The mean platelet count was 52 × 109/L (range 1-120 × 109/L). After 1 and 6 months, the overall response rate was: 61% and 33% with corticosteroids (n = 43), 80% and 50% with splenectomy (n = 10), and 14% and 60% with danazol (n = 15), respectively. Side effects of these therapies were reported in 100% of these elderly ITP patients, 60% and 50% with these drugs, respectively. No response was reported using IVIg. One case of fatal sepsis was noted after splenectomy. Conclusions: The results confirm (1) that age influences the hemorrhagic pattern of ITP expression, response, and adverse effects of conventional ITP therapies, and (2) that danazol has the potential to be an effective therapeutic alternative to splenectomy in elderly ITP patients.

    Original languageEnglish
    Pages (from-to)447-451
    Number of pages5
    JournalEuropean Journal of Internal Medicine
    Issue number6
    Publication statusPublished - Oct 2008


    • Age
    • Corticosteroids
    • Danatrol
    • Elderly
    • Idiopathic thrombocytopenic purpura
    • Splenectomy


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