Abstract
Objective: Here, we describe data and management experience of idiopathic thrombocytopenic purpura (ITP) in elderly patients. Methods: Retrospective study of 30 elderly patients over 65 years followed since 1985 in the University Hospital of Strasbourg (France). The analyzed data include: clinical characteristics, used therapies, their response rates and side effects at the 6th month. Results: Patients mean age was 71 years (range, 65 to 82); 12 patients were older than 75 years. The initial presentation included: thrombocytopenia revealed by a routine blood count in 6 patients (20%), bleeding limited to the skin in 7 cases (23%) and bleeding in one or more other sites (mucosa or visceral) in 17 patients (57%). The mean platelet count was 47 × 109/L (range, 1 to 120). During follow-up, 3 patients (10%) are died. Initially, a response to oral corticosteroid therapy was obtained in all treated patients (n = 14), but only one third of patients were responders after 6 months of follow-up. Adverse effects of corticosteroid therapy were reported in all patients. Three patients received an initial treatment of intravenous immunoglobulins; none of them presented any response. Initially, all splenectomized patients (n = 6) showed response to the splenectomy, but after 6 months of follow-up, none of these patients remained in complete response. Postoperative complications occurred in 4 patients, including a fatal one (septic shock). Danazol was given to 5 patients with a response in 60% of the cases. Moderate to severe elevation of serum aspartate or alanine aminotransferase was reported in all these patients. Conclusions: The present results show that ITP seem to be more severe in elderly patients. They suggest that age influences the response and adverse effects of various conventional therapies and that Danazol may be a potentially effective therapeutic alternative to splenectomy in elderly ITP patients.
Translated title of the contribution | Idiopathic thrombocytopenic purpura in elderly patients: Study of 30 patients over 65 years |
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Original language | French |
Pages (from-to) | 45-50 |
Number of pages | 6 |
Journal | Revue de Geriatrie |
Volume | 33 |
Issue number | 1 |
Publication status | Published - Jan 2008 |
Keywords
- Idiopathic thrombocytopenic purpura
- Older patient
- Treatment