Steroid Responsiveness

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Abstract
• Splenectomy is curative for many children with chronic immune thrombocytopenic purpura (ITP), but not without placing them at increased risk for serious infections. To determine the reliability of a trial of corticosteroids in predicting the outcome of splenectomy, 36 children with chronic ITP were studied retrospectively. All 20 of the children with a good response to corticosteroids achieved a complete remission after splenectomy, whereas only two of 13 nonresponders exhibited a lasting benefit from surgery. Corticosteroid responsiveness was found to be a highly reliable method of correctly identifying those patients with chronic ITP who would benefit from splenectomy. (Am J Dis Child1982;136:1064-1066)