Effect of high dose dexamethasone on platelets apoptosis in children
with Chronic Immune Thrombocytopenic Purpura
Abstract
Approximately 10 to 20 percent of children who present with ITP develop
chronic ITP, defined as platelet count <100,000/ micro L
lasting beyond 12 months from the time of presentation. Recently, it was
found that apoptosis may be one of the factors controlling the survival
and lifespan of the platelets in chronic ITP patients. High dose
dexamethasone (HD-DXM) was suggested as one of the effective modalities
of in treatment of chronic ITP. In this research we aim to detect the
level of apoptotic platelets in children with chronic ITP and to
evaluate the effect of high dose dexamethasone on platelets apoptosis in
these children. Patients and methods: twenty- six chronic ITP patients
and twenty-one age and sex matched healthy volunteers were exposed to
quantitative assessment of apoptotic platelets. HD-DXM was given to the
patients according to the treatment protocol with reassessment of the
apoptotic platelets after the end of the treatment. Results: the mean
levels of apoptotic platelets were significantly higher in patients
before treatment compared to control and when compared to patients after
treatment with HD-DXM. Conclusion: platelet apoptosis may play a role in
the pathogenesis of chronic ITP with good impact of HD-DXM on decreasing
apoptosis and increasing platelet count.