All issues > Volume 38(4); 1995

Original Article

J Korean Pediatr Soc. 1995;38(4):513-519. Published online April 15, 1995.

A Comparative Study o fIntavenous Methylprednisolone Dosage for Treatment of Children with Acute Idiopathic Thrombocytopenic Purpura

Eun Ju EJ Shin¹, Yeong Jae YJ Song¹, Woo Yeong WY Chung¹, Tae Gyu TG Hwang¹, Soon Yong SY Lee¹

¹Department of Pediatrics, Inje University College of Medicine, Pusan Paik Hospital, Pusan, Korea

Abstract

Purpose
: It is well known that use of intranenous methylprednisolone(IVMP)for the patients with idiopathic thrombocytopenic purpura(ITP) is not only as effective as use of intravenous gammaglobulin to mincrease platelets quickly, but also the former is less expensive than the latter. As the adequate dosage of IVMP has not been fully elucidated, we have tried to determine it.
Methods
: The subjects were 35 childhood patients below 15 years of age, who were diagnosed with ITP for the first time and whose platelet count was less than 20,000/mm3 at diagnosis. We divided them into three groups : Group A included 8 cases with IVMP dosage of 5mg/kg/day, Group B included 9 patients with IVMP dosage of 10mg/kg/day, and group C included 18 patients with IVMP dosage of 20mg/kg/day. We checked the platelet count every day after IVMP administration daily for 5 days and also observed for side effects if any.
Results
: After IVMP administration, we obseved increasing tendency of platelets in all three groups, of which group C was more rapid and higher in increasing platelets than the other groups(p<0.05). After IVMP therapy for 5 days, cases with platelets>20,000/mm3 were 6(75%) in group A, 7(78%) in group B, and 18(100%) in group C. Cases with platelets >50,000/mm3 were 5(63%), 6(67%), 17(94%) in groups A, B, C, respectively, and cases with platelets>100,000/mm3 were 3(38%), 5(56%), 14(78%), in group A, B, C, respectively. And there were no remarkable side effects except a case of transient hypertensive headache in group C.
Conclusion
: We concluded that the effectiveness of IVMP therapy for increasing platelets was more rapid and higher in group C than in group A or B, and side effect was minimal.

Keywords :Idiopathic thrombocytopenic purpura, Methylprednisolone